Morphological and Morphometric Study of Coronary Sinus in Human Cadaveric Hearts in Gujarat Region, India: A Cross-sectional Study

Abstract

Introduction: The major vein draining blood from the heart is the Coronary Sinus (CS). Its significance in facilitating numerous cardiac treatments such as biventricular pacing, and the placement of a variety of cardiac devices has made the CS a therapeutically essential structure. The development of advanced invasive and interventional cardiac procedures requires a thorough understanding of CS anatomy. Aim: To determine the location, shape, length, and width of the CS together with its left atrial muscular coverage in hearts of formalin-fixed cadavers. Materials and Methods: The present study was a cross- sectional study in which data was collected from 90 adult human cadaveric hearts preserved with formalin from both sexes. Forty cadaveric heart was obtained from Department of Anatomy, Pramukhswami Medical College, Karamsad and 50 from Dr. ND Desai Medical College and Hospital, Nadiad, Gujarat, India and study was conducted from August 2020 to July 2022. External Lengths (EL) of CS were measured using thread and Vernier Calliper at different levels (EL1-From the entry of oblique vein into CS and EL2-From the point of union of the great cardiac vein and left marginal vein upto its termination). CS width was measured: at the beginning, at the point where Middle Cardiac Vein (MCV) enters, and at the point where it terminates in the right atrium. CS walls were examined to see whether the muscles of the left atrium covered them or not. Using Statistical Package for the Social Sciences (SPSS) software, a descriptive analysis was conducted to determine the range, mean, and standard deviation. Results: In all 90 (100%) hearts, CS was found in the posterior atrioventricular sulcus. Tubular-shaped CS was found in 80 (88.9%) hearts, while 10 (11.1%) hearts had funnel-shaped CS. The EL1 of the CS was 43.75±4.68 mm and EL2 was 40.19±5.62 mm. The width of the CS was 6.71±1.47 mm at the beginning, 8.49±1.89 mm at the entrance point of MCV, the maximum width at termination in the right atrium was 8.14±2.16 mm and the minimum width was 5.16±1.70 mm. Muscles of the left atrium covered CS in all cases. Conclusion: The CS has a variable location, shape, length, and width despite being a constant component of the heart’s venous system. Its importance in giving access to various cardiac procedures has made it a clinically significant structure. The baseline data of this study can help the cardiologists performing various cardiac procedures in the Gujarat population.