Abstract
PurposeThere is no complex research exploring usefulness of cardiac magnetic resonance in the evaluation of the coronary sinus including Thebesian valve, which can be useful before selected electrophysiology procedures.MethodsOne hundred twenty-two patients aged 49.2 ± 17.2 (42 women) were included in the study; 4 of them were excluded. A steady-state free-precession (SSFP) sequence was the basis of the visualization and analysis of the coronary sinus as well as Thebesian valve. In selected cases, dedicated coronary sinus sequences were created. All data were evaluated by experienced cardiac magnetic resonance investigators.ResultsWe were able to visualize the coronary sinus by using basic SSFP sequence in all patients, however in four cases in suboptimal quality. Average length of the coronary sinus was 39.73 ± 16.9 mm, average diameter was 9.81 ± 9.3 mm, and average angle of the entrance of the coronary sinus into the right atrium was 111.37 ± 13.8°. The Thebesian valve as the gate of the coronary sinus was found in 56 cases (45.9 %). In 21 patients (17.2 % of all), the valve was porous or almost totally covered the coronary sinus ostium, which can potentially create problems during CS cannulation.ConclusionsIn most of the cases, it is possible to visualize and measure the coronary sinus using cardiac magnetic resonance with SSFP sequence. In selected cases, it is necessary to perform additional dedicated short sequences. Thebesian valve was visualized in almost 50 % of patients.
Highlights
The in vivo anatomy of the coronary sinus including an analysis of Thebesian valve as well as target veins has been described in many papers [1,2,3]
We were able to visualize the coronary sinus by using steady-state free-precession (SSFP) scans in all patients, Table 2 Proposed nomenclature for the types of Thebesian valves adapted from cardiac computed tomography [1]
Thebesian valve was visualized in half of the patients, which may provide a way to recognize problems for cardiac resynchronization therapy (CRT) implantation and other procedures
Summary
The in vivo anatomy of the coronary sinus including an analysis of Thebesian valve as well as target veins has been described in many papers [1,2,3]. The Thebesian valve is a caudal remnant of the embryonic sinoatrial valve It is usually a semicircular fold of membrane in the right atrium at the orifice of the coronary sinus. It is on the posterior, inferior surface of the heart, medial to the inferior vena cava opening [1, 4]. Experience from clinical practice suggests that the valve may pose difficulties during cannulation of the coronary sinus during cardiac resynchronization therapy (CRT). The most common method of in vivo visualization to date is cardiac computed tomography (CT) in
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
