Abstract
Background: Dimensions of the coronary sinus are important in the design of cannulation devices used in cardiac resynchronization therapy and percutaneous mitral valve annuloplasty. Gender and population variations may account for the failure rate of these procedures. Cardiac conditions requiring these procedures are common in black African populations. There are, however, hardly any studies on the regions of coronary sinus in these populations. Objective: To describe the regional diameters of coronary sinus among black Kenyans. Study design: Descriptive cross-sectional study. Materials and Methods: Coronary sinuses of 74 cadaveric hearts from black adult Kenyans (43 males and 31 females) were examined at Department of Human Anatomy, University of Nairobi, Kenya. Samples were classified into male and female and weighed. The coronary sinus was identified and cleaned to expose its entire extent. The length was divided into 3 segments; proximal, middle and distal. The circumference at the middle of each segment was obtained by measuring using a nylon string. This was divided by pie (3.14) to obtain the regional diameters. Data was analyzed using SPSS version 17. Sex comparison was established using student’s t test and Pearson’s correlation test was used to determine association between the diameters and heart weight. These were considered significant at a p-value of ≤0.05. Data were presented using scatter plots and tables. Results: The diameters at proximal, middle and distal segments were 8.67 ± 0.52 mm, 6.93 ± 0.77 mm and 5.83 ± 0.80 mm respectively. These correlated positively with weight of the heart. Females had significantly larger diameters. Conclusion: Diameters of coronary sinus show regional differences. They decrease distally, are larger in females and show positive correlation with weight of the heart. These features should be considered during design of and insertion of cardiac devices through the coronary sinus
Highlights
The coronary sinus (CS), the main venous drainage of heart, is an important access route for instruments used in different heart procedures such as arrhythmia ablation, biventricular pacing and deployment of various cardiac devices, percutaneous mitral annulopasty, retrograde cardioplegia perfusion and cardiac resynchronization therapy, inter alia [1,2,3,4]
Diameters of coronary sinus show regional differences. They decrease distally, are larger in females and show positive correlation with weight of the heart. These features should be considered during design of and insertion of cardiac devices through the coronary sinus
The CS was windsock-shaped originating at the point of confluence of great cardiac vein (GCV) and oblique vein of Marshall to terminate at the postero-inferior aspect of right atrium
Summary
The coronary sinus (CS), the main venous drainage of heart, is an important access route for instruments used in different heart procedures such as arrhythmia ablation, biventricular pacing and deployment of various cardiac devices, percutaneous mitral annulopasty, retrograde cardioplegia perfusion and cardiac resynchronization therapy, inter alia [1,2,3,4]. Knowledge of CS diameters is important to minimize failure rate [5], complications [6] and enhance operative success [7] during these procedures. These diameters show individual, gender and population variations [8,9]. There are, few data on diameters of coronary sinus among black populations of Africa. Dimensions of the coronary sinus are important in the design of cannulation devices used in cardiac resynchronization therapy and percutaneous mitral valve annuloplasty. Gender and population variations may account for the failure rate of these procedures Cardiac conditions requiring these procedures are common in black African populations. There are, hardly any studies on the regions of coronary sinus in these populations
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