Document Detail


Topographic analysis of the coronary sinus and major cardiac veins by computed tomography.
MedLine Citation:
PMID:  15992723     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The coronary sinus (CS) and its branches may play a role in the genesis of various arrhythmias. Applications of radiofrequency energy within the CS may be necessary. Atrio-esophageal fistula has been recognized as a complication of ablation along the posterior left atrial wall. OBJECTIVES: The purpose of this study was to describe the in vivo topographic anatomy of the CS, esophagus, and coronary arteries using computed tomography (CT). METHODS: Helical contrast CT of the heart with three-dimensional and endoscopic reconstructions was performed in 50 patients (28 men and 22 women; mean age 54 +/- 10 years). The images were reformatted to determine the relationships among the CS, adjacent blood vessels, and esophagus and to determine the nature and thickness of surrounding tissue layers. RESULTS: Mean CS ostium diameter was 12 +/- 4 mm, and mean thickness of the periosteal fat layer was 3 +/- 2 mm. In 40 of the 50 patients (80%), the esophagus was adjacent to the CS, starting 24 +/- 9 mm from the ostium, and remained in contact for a mean length of 7 +/- 5 mm. Mean thickness of the fat layer between the esophagus and CS was 1 +/- 1 mm, and mean thickness of the anterior wall of the esophagus was 3 +/- 2 mm. In 10 patients (20%), there was no contact between the esophagus and CS. In 40 patients (80%), the right coronary artery was less than 5 mm from the CS (minimum distance 1 +/- 1 mm) over a mean length of 17 +/- 11 mm. In all patients, the circumflex artery was less than 5 mm from the CS (minimum distance 1 +/- 0.4 mm) over a mean length of 16 +/- 9 mm in patients with right-dominant coronary circulation and over a mean length of 86 +/- 11 mm in patients with left-dominant coronary circulation. CONCLUSION: The CS often lies very close to the esophagus and coronary arteries. During radiofrequency energy ablation in the CS, caution should be exercised to prevent injury to surrounding structures.
Authors:
Kristina Lemola; Gisela Mueller; Benoit Desjardins; Michael Sneider; Ian Case; Eric Good; Jihn Han; Kamala Tamirisa; David Tschopp; Scott Reich; Petar Igic; Darryl Elmouchi; Aman Chugh; Frank Bogun; Frank Pelosi; Ella A Kazerooni; Fred Morady; Hakan Oral
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  2     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-10-27     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  694-9     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan 48109-0311, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aortic Aneurysm, Thoracic / pathology,  physiopathology,  radiography*
Atrial Fibrillation / pathology,  physiopathology,  radiography*
Coronary Artery Disease / pathology,  physiopathology,  radiography*
Coronary Circulation / physiology
Coronary Vessels / pathology*,  physiopathology
Electrocardiography
Esophagus / radiography
Female
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Tomography, Spiral Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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