Study of coronary sinus anatomy during levophase of coronary angiography  

作　　者：Akshyaya Pradhan Vrishank Bajaj Pravesh Vishwakarma Monika Bhandari Akhil Sharma Gaurav Chaudhary Sharad Chandra Rishi Sethi Varun Shankar Narain Sudhanshu Dwivedi 

机构地区：[1]Department of Cardiology,King George Medical University,Lucknow 226003,Uttar Pradesh,India

出　　处：《World Journal of Cardiology》2022年第6期372-381,共10页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Coronary sinus(CS)imaging has recently gained importance due to increasing need for mapping and ablation of electrophysiological arrhythmias and left ventricular(LV)pacing during cardiac resynchronization therapy(CRT).Retrograde venogram is the current standard for imaging CS and its tributaries.AIM To evaluate CS anatomy during levophase of routine coronary angiography to aid LV lead implantation during CRT.METHODS In this prospective observational study,164 patients undergoing routine coronary angiography for various indications(Chronic stable angina-44.5%,acute coronary syndrome-39.5%,Dilated cardiomyopathy-11%,atypical chest pain-5%)were included.Venous phase(levophase)of left coronary injection was recorded in left anterior oblique-cranial and right anterior oblique-cranial views.Visibility of coronary veins,width and shape of CS ostium,angulations of proximal CS with body of CS were noted.Presence,size,take-off angle and tortuosity of posterolateral vein(PLV),anterior interventricular veins(AIV)and middle cardiac vein(MCV)were also noted.RESULTS During levophase,visibility grade(Muhlenbruch grade)for coronary veins was 3 in 74%and 2 in 26%of cases.Visibility of CS did not correlate with body mass index.The diameter of CS ostium was<10 mm,10-15 mm and>15 mm in 48%,42%and 10%of patients respectively.Proximal CS was tubular in 136(83%)patients and funnel-shaped in 28(17%)patients.Sharp take-off angulation between ostium and body of CS was seen in 16(10%)patients.Two or more PLV were present in 8 patients while PLV was absent in 52(32%)patients.Angle of take-off of PLV with body of CS was favourable(0°-45°)in 65(40%)patients.The angle was 45°-90°in 36 patients and difficult take-off angle(>90°)was seen in 8 patients.Length of PLV reached distal third of myocardium in 84 cases and middle third in 11 cases.There was no tortuosity in 79 cases,a single bend in 29 cases and more than 2 bends in 4 cases.Thirty nine(24%)patients had other veins supplying posterior/Lateral wall of LV.There was a single

关 键 词：Posterolateral vein Ostium ANGIOGRAPHY Sharp take off Favourable angulation 

分 类 号：R816.2[医药卫生—放射医学] R54[医药卫生—临床医学]