Duplicated coronary sinus with a connecting branch
Takumi Yamada1, Hugh Thomas McElderry, Vance J Plumb
1Division of Cardiovascular Disease, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd Avenue Street, Birmingham, AL 35294-0019, USA. takumi-y@fb4.so-net.ne.jp
Summary
A rare duplicated coronary sinus anomaly was identified during cardiac resynchronization therapy implantation. This finding highlights potential risks during procedures involving the coronary sinus.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Anatomical Variations
Background:
- Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
- Accurate anatomical visualization is crucial for CRT device implantation.
- Coronary sinus (CS) cannulation is a key step in CRT procedures.
Observation:
- A 48-year-old woman with heart failure and left bundle branch block underwent CRT implantation.
- Coronary sinus venography revealed a duplicated CS.
- An unusual origin and course of the antero- and postero-lateral branches were noted.
Findings:
- The antero- and postero-lateral branches appeared to originate from a single duplicated CS vessel.
- A connecting branch visualized a separate antero-lateral branch.
- Distal portions of these vessels were superimposed in the RAO view.
Implications:
- This duplicated CS anomaly presents unique challenges for lead placement.
- Potential risks include vessel perforation during CS cannulation.
- Awareness of such anatomical variations is vital for procedural safety.
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