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Anatomical barriers in the right atrium to the coronary sinus cannulation

Wiesława Klimek-Piotrowska1, Mateusz K Hołda1, Mateusz Koziej1

  • 1Department of Anatomy, Jagiellonian University , Cracow , Poland.

Peerj
|January 30, 2016
PubMed

Insights

Anatomical structures in the right atrium, such as the Eustachian valve, can impede coronary sinus catheterization during cardiac procedures. Understanding these barriers is crucial for successful minimally invasive interventions.

Area of Science:

  • Cardiovascular Anatomy
  • Interventional Cardiology

Background:

  • The coronary venous system is a key target for minimally invasive cardiac procedures.
  • Coronary sinus catheterization is a critical component of these interventions.

Purpose of the Study:

  • To evaluate anatomical variations within the right atrium that may obstruct coronary sinus cannulation.
  • Identify potential barriers to catheter-based procedures targeting the coronary sinus.

Main Methods:

  • Examination of 110 autopsied human hearts (both sexes).
  • Detailed anatomical assessment of the right atrium, coronary sinus ostium, and vena cava ostia.
  • Analysis of structures including the Eustachian valve and Chiari's network.

Main Results:

  • Eustachian valve present in 71.8% of hearts; typically not a significant barrier, but large valves (approx. 2%) can impede cannulation.
  • Chiari's network (4.6%) may hinder intra-cardiac catheter manipulation.
  • Thebesian valve generally allows passage of standard catheters to the coronary sinus.

Conclusions:

  • Specific anatomical features within the right atrium present variable challenges for coronary sinus cannulation.
  • Awareness of these anatomical barriers is essential for interventional cardiologists performing procedures targeting the coronary venous system.

Keywords:
Chiari’s networkEustachian valveHeart anatomyTendon of TodaroThebesian valve

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