Publication

Abstract :

Background & Aims: The coronary venous system is an emerging field of interest for cardiologists with advancement of the electrophysiological procedures. Transcatheter coronary sinus interventional therapy is a promising method to treat coronary heart diseases. Thebesian valve (TV), Vieussens valve (Vv), and bend of the great cardiac vein (GCV) are commonly encountered obstacles in the passage of catheter. In this study, we aimed to evaluate the factors causing complications and obstruction to coronary venous catheterization.
Materials & Methods: In this cross-sectional observational study, we examined 110 formalin-fixed cadaveric hearts. The height of TV, the transverse and craniocaudal diameter of coronary sinus ostium (CSO), length, diameter, and angle of bend of GCV were measured. The presence or absence of Vv was noted. The morphological characteristics of TV and the percentage of CSO coverage by TV were recorded.
Results: The TV and Vv were observed in 91 (82.7%) and 59 (53.63%) specimens respectively. Remnant (8.2%), semilunar (52.1%), fold (10%), cord (3.6%), and fenestrated (8.2%) morphologies of TV were reported. In 16 (20.5%) hearts, Thebesian valve was covering more than 75% of CSO. Hearts with larger diameter of CSO presented smaller height of TV. The mean length and diameter of GCV were measured as 135.1 ± 31.6 mm and 4.31 ± 1.44 mm respectively. The mean angle of bend of GCV was calculated as 104.1 degrees. The acute angle was observed in 3.6% of specimens.
Conclusion: Knowledge of the obstructive anatomical structures and their variations can be helpful in the optimization of a more suitable invasive technique for invasive cardiology.