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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

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|April 18, 2008
PubMed

Insights

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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