Abstract
Visualization of the Thebesian valve - guard of the coronary sinus (CS) - can be possible in the cardiac magnetic resonance (CMR). Such pre-visualization can potentially be valuable before cannulation of the CS. Methods: 122 patients (aged 49.2 ± 17.2; 41W) were included. CMR was performed on all participants using a GE Optima MR450w 1.5T (GEM) with a 3D cardiac coil. A standard steady-state free precession and 4-channel long axis sequences were used for the basic evaluation of the Thebesian valve. Our original sequence or navigator gated 3D free breathing CMR were performed on selected patients. The classification of the Thebesian valve in CMR was based on anatomical characteristics. Results: Examples of the Thebesian valve in CMR are presented in the figure below. Average diameter of the CS ostium was 9.9 ± 9.3 mm. Thebesian valve was found in 56 patients (45.9%). Average diameter of the CS ostium in patients with a valve present was 11.9 ± 17.9 and without Thebesian valve was 8.9 ± 0.4; p = 0.429 NS. In 21 patients (37.5%) the valve almost totally covered the CS ostium (type D); this can potentially create problems during CS cannulation. In 20 (35.7%) cases, the valve was visible from the right atrium wall (types A1, A2) and in one case (1.8%), it was visible from the inter-atrial septum (type B1). In 12 (21.4%) cases, the valve had two parts with a gap between them (type C).
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