Characterization of human coronary sinus valves by direct visualization during biventricular pacemaker implantation

Pacing and Clinical Electrophysiology : PACE
D J AnhAmin Al-Ahmad

Abstract

The precise reasons for failure to cannulate the coronary sinus during biventricular device implantation are unknown. Visualization of the coronary sinus ostium during electrophysiology procedures may enhance understanding of how unusual anatomy can affect successful cannulation of the coronary sinus. The aim of this study was to describe the morphology of valves at the coronary sinus ostium (CSO) visualized directly with an illuminated fiberoptic endoscope during implantation of biventricular devices. The coronary sinus anatomy of one hundred consecutive patients undergoing implantation of biventricular devices was investigated using a fiberoptic endocardial visualization catheter (EVC). The CSO was clearly visualized in 98 patients using the EVC. A Thebesian valve was seen in 54% of these. Almost all Thebesian valves were positioned at the inferior (61%) or posterior (33%) aspect of the CSO. Only six patients had Thebesian valves that covered more than 70% of the CSO, but all were successfully implanted with a transvenous left ventricular pacing lead after cannulating the coronary sinus under direct visualization. Over half of patients undergoing biventricular device implantation have identifiable Thebesian valves. Even valve...Continue Reading

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Citations

Aug 10, 2012·PloS One·Peter LeeChristopher E Woods
Jan 30, 2016·PeerJ·Wiesława Klimek-PiotrowskaMarcin Strona
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Jul 10, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Gary S MakSubramaniam C Krishnan
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