Mateusz K Hołda1, Wiesława Klimek-Piotrowska2, Mateusz Koziej2, Małgorzata Mazur2. 1. Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, Kraków 31-034, Poland mateusz_holda@onet.eu. 2. Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, Kraków 31-034, Poland.
Abstract
AIMS: The Thebesian valve (TV) can be a significant obstacle to coronary sinus (CS) cannulation. The aim of this study was to evaluate the characteristic features of the CS valve--TV anatomy. In particular, emphasis was placed on identifying specific structures of the TV that could potentially complicate CS cannulation. METHODS AND RESULTS: We examined 273 autopsied human hearts. The height of the TV and the diameter of the CS were measured. The valves were classified according to their shape into five types: remnant, semilunar, fold, cord, and mesh and fenestrated. The mean transverse CS ostium (CSO) diameter was 12.2 ± 3.5 mm. The TV was present in 224 (82.1%) cases. The most common type of TV was semilunar: 32.6%; followed by remnant: 25.5%; fold: 17.4%; cord: 14.3%; and lastly mesh and fenestrated: 10.3%. The mean TV height for remnant-semilunar-fold types was 5.8 ± 3.0 mm. In seven cases, the present TV (2.6%) covered the entire orifice of the CS. Hearts with larger CSO diameter had lower TV height (P < 0.001). CONCLUSIONS: We propose a new classification of the TV shapes based on the largest sample to date. We assessed that only in 2.6% of all 273 cases the presence of an obstructive TV can cause unsuccessful cannulation. The height of the TV was inversely correlated to the CSO diameter (r = -0.33; P < 0.001). Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The Thebesian valve (TV) can be a significant obstacle to coronary sinus (CS) cannulation. The aim of this study was to evaluate the characteristic features of the CS valve--TV anatomy. In particular, emphasis was placed on identifying specific structures of the TV that could potentially complicate CS cannulation. METHODS AND RESULTS: We examined 273 autopsied human hearts. The height of the TV and the diameter of the CS were measured. The valves were classified according to their shape into five types: remnant, semilunar, fold, cord, and mesh and fenestrated. The mean transverse CS ostium (CSO) diameter was 12.2 ± 3.5 mm. The TV was present in 224 (82.1%) cases. The most common type of TV was semilunar: 32.6%; followed by remnant: 25.5%; fold: 17.4%; cord: 14.3%; and lastly mesh and fenestrated: 10.3%. The mean TV height for remnant-semilunar-fold types was 5.8 ± 3.0 mm. In seven cases, the present TV (2.6%) covered the entire orifice of the CS. Hearts with larger CSO diameter had lower TV height (P < 0.001). CONCLUSIONS: We propose a new classification of the TV shapes based on the largest sample to date. We assessed that only in 2.6% of all 273 cases the presence of an obstructive TV can cause unsuccessful cannulation. The height of the TV was inversely correlated to the CSO diameter (r = -0.33; P < 0.001). Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Jakub Hołda; Katarzyna Słodowska; Karolina Malinowska; Marcin Strona; Małgorzata Mazur; Katarzyna A Jasińska; Aleksandra Matuszyk; Mateusz Koziej; Jerzy A Walocha; Mateusz K Hołda Journal: Diagnostics (Basel) Date: 2021-05-26
Authors: Sylwia Sławek-Szmyt; Krzysztof Szmyt; Czesław Żaba; Marek Grygier; Maciej Lesiak; Aleksander Araszkiewicz Journal: Europace Date: 2021-11-08 Impact factor: 5.214