Aortic sinus

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An aortic sinus, also known as a sinus of Valsalva,[1] is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve. These widenings are between the wall of the aorta and each of the three cusps of the aortic valve.[2]

Aortic sinus
Aorta laid open to show the semilunar valves. (N.B. captions don't align with current terminology)
Details
Synonymssinus of Valsalva
Identifiers
Latinsinus aortae
MeSHD012850
TA98A12.2.03.002
TA24001
FMA3745
Anatomical terminology

The aortic sinuses cause eddies which prevent the valve cusps from touching the internal surface of the aorta and obstructing the openings of the coronary arteries.[3]

Structure

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There are generally three aortic sinuses, one anterior and two posterior sinuses. These give rise to coronary arteries:[4][better source needed]

  • The left aortic or left posterior aortic sinus gives rise to the left coronary artery;
  • The right aortic or anterior aortic sinus gives rise to the right coronary artery;
  • The posterior aortic or right posterior aortic sinus usually gives rise to no vessels. It is often known as the non-coronary sinus.

The aortic sinuses are typically more prominent than the pulmonary sinuses.[5]

Clinical significance

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If the coronary arteries arise from the wrong aortic sinuses, this can put the heart's ventricles at risk of ischaemia.[6] This is often only discovered when a heart attack has already occurred, usually before the age of 20 and during exercise.[6]

Names

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Each aortic sinus can also be referred to as the sinus of Valsalva,[1] the sinus of Morgagni, the sinus of Mehta, the sinus of Otto, or Petit's sinus.

See also

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References

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  1. ^ a b Weinreich, Michael; Yu, Pey-Jen; Trost, Biana (2015). "Sinus of Valsalva Aneurysms: Review of the Literature and an Update on Management". Clinical Cardiology. 38 (3): 185–189. doi:10.1002/clc.22359. ISSN 1932-8737. PMC 6711005. PMID 25757442.
  2. ^ Dorland's (2012). Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier. p. 1719. ISBN 978-1-4160-6257-8.
  3. ^ Koeppen, Bruce M.; Stanton, Bruce A.; Swiatecka-Urban, Agnieszka, eds. (2024). Berne & Levy Physiology (8th ed.). Philadelphia, PA: Elsevier. ISBN 978-0-323-84790-2.
  4. ^ Deng, Francis. "Sinus of Valsalva | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 2023-01-08.
  5. ^ Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (2012-01-01), Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (eds.), "Chapter 23 - Adenosine-Sensitive (Outflow Tract) Ventricular Tachycardia", Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald's Heart Disease (Second Edition), Philadelphia: W.B. Saunders, pp. 562–586, doi:10.1016/b978-1-4557-1274-8.00023-3, ISBN 978-1-4557-1274-8, retrieved 2020-11-11
  6. ^ a b Thiene, G.; Rizzo, S.; Basso, C. (2016-01-01), Buja, L. Maximilian; Butany, Jagdish (eds.), "Chapter 10 - Pathology of Sudden Death, Cardiac Arrhythmias and Conduction System", Cardiovascular Pathology (Fourth Edition), San Diego: Academic Press, pp. 361–433, doi:10.1016/b978-0-12-420219-1.00010-0, ISBN 978-0-12-420219-1, retrieved 2020-11-11
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