Improved Coronary Sinus Blood Sampling for Cardiac Research

Abstract

Background: Coronary sinus (CS) blood sampling is important for measuring metabolites and biomarkers in cardiovascular research, but can be technically challenging. Here we demonstrate the use of the antecubital fossa for CS blood sampling as an alternative to femoral access, and a simple technique of paired venous and CS blood gas analysis for confirmation of valid CS sampling. We also demonstrate improvement in sampling accuracy by using a coronary guide wire to stabilize the sampling catheter in the CS. Methods: Paired blood samples from CS and peripheral vein were collected from patients at the time of primary PCI for acute myocardial infarction. Venous access for CS sampling was via the antecubital vein. Blood gas analysis was used to confirm a true CS sample (pO2[CS]<pO2[v]). CS sampling was carried out with a catheter in the CS (standard technique) or with the addition of a coronary guide wire for stability (modified technique). Results: 108 patients underwent CS and peripheral venous blood sampling. The standard technique for CS sampling was used in 62 patients and the modified technique in 46 patients. Blood gas analysis confirmed a true CS sample in 77% of patients using the standard technique and 100% using the modified technique. Conclusions: CS blood sampling via the antecubital fossa is feasible and safe. Blood gas analysis of paired venous and CS samples can be used to confirm a valid CS sample. A coronary guide wire can be used to stabilise the sampling catheter in the CS, and this increases CS sampling accuracy.