Coronary sinus anatomical features: Description and procedural implications during coronary sinus Reducer...

Area of Science:

• Cardiology
• Interventional Cardiology
• Anatomical Studies

Background:

• Rising prevalence of chronic angina cases unresponsive to conventional treatments.
• Coronary sinus Reducer (CSR) implantation as an emerging therapeutic option for refractory angina.
• Need for procedural optimization in CSR implantation.

Purpose of the Study:

• To investigate the impact of coronary sinus (CS) anatomy on the ease and efficiency of CSR implantation.
• To identify specific CS anatomical variations that may simplify the CSR procedure.
• To provide insights for interventional cardiologists regarding procedural planning.

Main Methods:

• Retrospective analysis of 47 CSR implantations.
• Classification of CS anatomy into 'C-shape' (horizontal proximal CS) and 'non-C-shape'.
• Comparison of procedural time, fluoroscopic exposure, contrast volume, and complications between the two anatomical groups.

Main Results:

• The C-shape CS anatomy was associated with significantly shorter procedural times (20.0 vs. 24.5 min, p=0.028).
• Fluoroscopic time was also significantly reduced in patients with C-shape CS anatomy (9.5 vs. 11.0 min, p=0.016).
• No significant differences were observed in contrast use or procedural complications; presence of valves/bifurcations did not affect timings.

Conclusions:

• The study identifies a favorable 'C-shape' CS anatomy that streamlines CSR implantation.
• Awareness of CS anatomical variations is crucial for improving guiding catheter stability and reducing procedural complexity.
• This systematic evaluation offers practical guidance for enhancing CSR procedural outcomes.