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Morphological and Morphometric Study of Coronary Sinus in North Indian Population
Beegum Zabina1, Rajan Kumar Singla2, Ravi Kant Sharma3
1Junior Resident, Department of Anatomy, Government Medical College, Amritsar, Punjab, India.
Insights
The coronary sinus (CS) is a key cardiac vein with variable anatomy. Understanding these variations in location, shape, and size is crucial for successful cardiac procedures.
Area of Science:
- Cardiac Anatomy
- Vascular Anatomy
- Surgical Anatomy
Background:
- The coronary sinus (CS) is the largest cardiac vein, vital for draining blood from the heart.
- It serves as a critical access point for various cardiac interventions, including biventricular pacing and arrhythmia ablation.
Purpose of the Study:
- To investigate the anatomical variations of the coronary sinus (CS) in human cadavers.
- Specifically, to document the location, shape, length, and width of the CS, as well as its left atrial muscular coverage.
Main Methods:
- Analysis of 50 adult human cadaveric hearts.
- Measurements of CS external and internal lengths, and width at three distinct levels.
- Assessment of left atrial muscular coverage of the CS walls.
Main Results:
- The CS was consistently located in the posterior atrioventricular sulcus (98% of cases).
- Observed shapes included funnel (82%) and tubular/cylindrical (18%).
- Significant variability was noted in external and internal lengths, with maximum width at the termination; 96% showed left atrial muscular coverage.
Conclusions:
- The coronary sinus (CS) exhibits considerable anatomical variability in its dimensions and morphology.
- Awareness of these variations is essential for cardiac surgeons and interventional cardiologists, particularly for procedures like cardiac resynchronization therapy and device implantation.
Introduction:
Coronary sinus (CS) is the largest vein draining the blood from heart. It is a muscular tube of about 2 cm to 3 cm length and 1 cm in caliber. It has become a clinically important structure through its role in providing access for different cardiac procedures viz., biventricular pacing, arrhythmia ablation and for deployment of an array of cardiac devices.
Aim:
To study the location, shape, length and width of CS including its left atrial muscular coverage in 50 cadaveric hearts.
Materials And Methods:
The present study comprised of 50 adult human apparently normal formalin fixed cadaveric hearts belonging to either sex obtained from the Department of Anatomy, Government Medical College, Amritsar, India. Location and shape of CS were noted, external and internal lengths of the CS were measured with the help of a thread and Vernier caliper. Width of CS was measured at three levels; at the beginning, at the point of entry of Middle Cardiac Vein (MCV) and at termination in right atrium. The walls of CS were examined to note whether they were covered by the muscles of left atrium or not. Descriptive analysis was done to calculate range, mean and Standard Deviation (SD) by using Statistical Package for Social Science (SPSS) 17.0.
Results:
CS was located in the posterior atrioventricular sulcus in 98%. Two shapes; funnel in 82% and tubular/cylindrical in 18% were observed. External length of coronary sinus ranged from 20.5 mm to 58.78 mm (mean 38.22±8.6 mm) and internal length ranged from 16.28 mm to 49.6 mm (mean 34.48±8.9 mm). Maximum width of coronary sinus was at its termination (9.61±2.6 mm) and it was covered by muscles of left atrium in 96% of hearts.
Conclusion:
CS is a constant structure in cardiac venous anatomy but its location, shape, length and width are variable. Knowing these variations can help cardiac surgeons especially during cardiac resynchronization therapy, ablation and defibrillation.
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