Related Experiment Video

Updated: May 7, 2026

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
09:57

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement

Published on: January 20, 2022

Obstructive Thebesian valve: anatomical study and implications for invasive cardiologic procedures

Sanjib Kumar Ghosh1, Shashi Raheja, Anita Tuli

  • 1Department of Anatomy, Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital, Shaheed Bhagat Singh Marg, New Delhi, 110001, India, drsanjib79@gmail.com.

Anatomical Science International
|September 18, 2013
PubMed

Insights

Obstructive Thebesian valves, remnants of the right sinoatrial valve, can impede coronary sinus cannulation. Targeting the cranial margin of the coronary sinus ostium may improve success rates in challenging cases.

Area of Science:

  • Cardiovascular Anatomy
  • Interventional Cardiology

Background:

  • The Thebesian valve, an embryological remnant, guards the coronary sinus ostium.
  • Cannulation of the coronary sinus is crucial for advanced cardiac procedures.
  • Obstructive Thebesian valves can hinder successful coronary sinus cannulation.

Purpose of the Study:

  • To investigate the morphology of Thebesian valves and coronary sinus ostia.
  • To assess the impact of these structures on invasive cardiac procedures.
  • To identify factors influencing successful coronary sinus cannulation.

Main Methods:

  • Dissection of 150 human cadaveric heart specimens.
  • Classification of Thebesian valves by shape (semilunar, fenestrated, biconcave band-like) and composition (membranous, fibromuscular, fibrous, muscular).
  • Definition of obstructive Thebesian valves based on coverage (>75%) and morphology.

Main Results:

  • Thebesian valves were present in 79% of specimens; 18% were classified as obstructive.
  • Semilunar valves (55%) were most common and associated with smaller coronary sinus ostium diameters.
  • The cranial margin of the coronary sinus ostium was consistently free of Thebesian valve attachment.

Conclusions:

  • Obstructive Thebesian valves pose a challenge to coronary sinus cannulation.
  • The morphology and coverage of Thebesian valves influence cannulation success.
  • Directing catheter tips towards the cranial margin of the coronary sinus ostium may enhance cannulation success.

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Cardiac Catheterization III: Left Heart Catheterization01:24

Cardiac Catheterization III: Left Heart Catheterization

Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...