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Background: Invasive cardiac procedures, such as arrhythmia ablation, cardiac resynchronisation therapy, percutaneous mitral annuloplasty and retrograde cardioplegia delivery require cannulation of the coronary sinus (CS). Detailed knowledge of the CS ostium region, including recognition of the presence of the Thebesian valve which sometimes covers the sinus, is a key to successfully carry out such procedures. Materials and methods: In the present study, 160 autopsied human hearts from both sexes were examined for the presence of the Thebesian valve. If identified, the histological structure of the valve was studied. Results: Five types of the CS valve were distinguished; all of them presented with a typical histological structure with the exception of the cord-like type, in which cells were similar to those of the conduction system of the heart. Conclusions: Proper identification of the CS valve and analysis of its size and histological features could have important implications for electrophysiologists. (Folia Morphol 2014; 73, 3: 298–301)
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Opis fizyczny
p.298-301,fig.,ref.
Twórcy
autor
- Department of Anatomy, Medical College, Jagiellonian University, Krakow, Poland
autor
- Department of Pathomorphology, Medical College, Jagiellonian University, Krakow, Poland
autor
- Department of Anatomy, Medical College, Jagiellonian University, Krakow, Poland
autor
- Department of Anatomy, Medical College, Jagiellonian University, Krakow, Poland
autor
- Department of Anatomy, Medical College, Jagiellonian University, Krakow, Poland
Bibliografia
- 1. Anderson R, Yanni J, Boyett M, Chandler N, Dobrzynski H (2009) The anatomy of the cardiac conduction system. Clin Anat, 22: 99–112.
- 2. Anh DJ, Eversull CS, Chen HA, Mofrad P, Mourlas NJ, Mead RH, Zei PC, Hsia HH, Wang PJ, Al-Ahmad A (2008) Characterization of human coronary sinus valves by direct visualization during biventricular pacemaker implantation. Pacing Clin Electrophysiol, 1: 78–82.
- 3. Cao M, Chang P, Garon B, Shinbane J (2012) Cardiac resynchronization therapy: double cannulation approach to coronary venous lead placement via a prominent Thebesian valve. PACE, 36: 70–73.
- 4. Cozma D, Mornos C (2006) Electrophysiological and echocardiographics parameters predisposing to atrial fibrillation in patients with structurally normal heart. Kardiol Pol, 64: 143–150.
- 5. de Oliveira IM, Scanavacca MI, Correia AT, Sosa EA, Aiello VD (2007) Anatomic relations of the Marshall vein: importance for catheterization of the coronary sinus in ablation procedures. Europace, 10: 915–919.
- 6. Habib A, Lachman N, Christensen KN, Asirvatham SJ (2009) The anatomy of the coronary sinus venous system for cardiac electrophysiologist. Europace, 11: 15–21.
- 7. Karaca M, Bilge O, Dinckal M, Ucerler H (2005) The anatomic barriers In the coronary sinus: implcations for clinical procedures. J Intern Cardiol Electrophysiol, 14: 89–94.
- 8. Katti K, Patil NP (2012) The Thebesian valve: gatekeeper to the coronary sinus. Clin Anat, 25: 379–385.
- 9. Kautzner J (2009) Thebesian valve: the guard dog of the coronary sinus? Europace, 11: 1136–1137.
- 10. Lewicka-Nowak E, Sterliński M, Dąbrowska-Kugacka A, Maciąg A (2005) Problemy i niepowodzenia związane ze stosowaniem stymulacji dwukomorowej u pacjentów z zaawansowaną niewydolnością serca. Cardiol J, 5: 343–348.
- 11. Mak GS, Hill AJ, Moisiuc F, Krishnan SC (2009) Variations in Thebesian valve anatomy and coronary sinus ostium: implications for invasive electrophysiology procedures. Europace, 9: 1136–1137.
- 12. Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP, Estes NA 3rd, Foster E, Greenberg H, Higgins SL, Pfeffer MA, Solomon SD, Gilber D, Zareba W (2009) Cardiac resynchronization therapy for the prevention of heart-failure events. N Engl J Med, 361: 1329–1338.
- 13. Oginosawa Y, Abe H, Nakashima Y (2006) Prevalence of venous anatomic variants and occlusion among patients undergoing implantation of transvenous lead. Pacing Clin Electrophysiol, 28: 425–428.
- 14. Parikh GM, Halleran SM, Bharati S, Trohman RG (2011) Successful percutaneous cardiac resynchronization despite an occlusive Thebesian valve. Pediatr Card, 32: 1223–1227.
- 15. Pejkovic B, Krajnc I, Anderhuber F, Kosutic D (2008) Anatomical variations of the coronary sinus ostium area of the human heart. J Int Med Res, 2: 314–321.
- 16. Singh JP, Houser S, Heist K, Ruskin J (2005) The coronary venous anatomy. J Am Coll Cardiol, 1: 68–74.
- 17. Tang ASL, Wells GA, Talajic M, Arnold MO, Sheldon R, Connolly S, Hohnloser SH, Nichol G, Birnie DH, Sapp JL, Yee R, Healey JS, Rouleau JL (2010) Cardiac resynchronization therapy for mild-moderate heart failure. N Engl J Med, 363: 2385–2395.
Typ dokumentu
Bibliografia
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