Related Experiment Video

Updated: May 17, 2026

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
06:02

Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens

Published on: April 18, 2013

Variance in coronary venous anatomy: a critical determinant in optimal candidate selection for cardiac

Arpandeep Randhawa1, Abhimanyu Saini, Anjali Aggarwal

  • 1Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Pacing and Clinical Electrophysiology : PACE
|October 31, 2012
PubMed

Insights

Understanding coronary sinus anatomy is crucial for cardiac resynchronization therapy. Variations like restrictive Thebesian valves and acute tributary angles can hinder left ventricle lead placement.

Area of Science:

  • Anatomy
  • Cardiovascular System
  • Medical Device Placement

Background:

  • Knowledge of coronary sinus (CS) anatomy is vital for successful left ventricle lead placement during cardiac resynchronization therapy (CRT).
  • Anatomical variations can significantly impact procedural outcomes.

Purpose of the Study:

  • To investigate the anatomical variations of the coronary venous system.
  • To identify specific anatomical features that may impede cannulation of the coronary sinus for CRT lead placement.

Main Methods:

  • A detailed anatomical study was conducted on 50 formalin-fixed adult cadaveric hearts.
  • Analysis included the number, diameter, and opening angles of coronary venous tributaries.

Main Results:

  • Thebesian valve (TV) and Vieussens valve were observed in 64% and 60% of cases, respectively.
  • Restrictive TV coverage (≥75% of CS ostium) occurred in 25% of hearts.
  • Single prominent tributaries and acute tributary angles with the CS axis were noted in a significant percentage of cases.

Conclusions:

  • Restrictive Thebesian valves, single prominent tributaries, and acute tributary angles can impede successful coronary sinus cannulation.
  • These anatomical factors are critical considerations for electrophysiologists performing CRT.
  • Awareness of these variations can improve procedural success rates in CRT.
Abstract

More Related Videos

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Cardiac Catheterization II: Right Heart Catheterization01:21

Cardiac Catheterization II: Right Heart Catheterization

Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...