February 15, 2000Circulation406 citations
The Anatomic Basis of Connections Between the Coronary Sinus Musculature and the Left Atrium in Humans
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Key Result
Histological analysis of 10 necropsied human hearts revealed consistent myocardial connections between the coronary sinus and left atrium, extending 40+/-8 mm from the ostium.
Key Points
- This research investigates the histological characteristics of the myocardial connections between the coronary sinus and the left atrium in humans.
- Ten necropsied human hearts were analyzed using serial longitudinal sections through the coronary sinus.
- Measurements were taken to detail the striated muscle cuff and connections to the left atrium.
- Striated muscle cuff around the coronary sinus measured 40±8 mm.
- Connections varied in number from 1 to 2 fascicles to a continuum, with dimensions of 2.79±2 mm thickness and 2.91±3.5 mm width.
- The valve of Vieussens was observed in 6 hearts at a mean distance of 3.4±3.2 mm from the coronary sinus muscle cuff.
Study Design
Type
Observational (n=10)
Structured PICO
P
Population
10 necropsied human hearts
I
Intervention
Histological examination using serial longitudinal sections parallel to the long axis of the coronary sinus
O
Outcome
Histological features of the atrial myocardium connecting the coronary sinus and the left atrium
The study demonstrates consistent but morphologically variable myocardial connections between the coronary sinus and left atrium, highlighting the anatomical basis for arrhythmias and the need for targeted ablation in this region.
Abstract
BACKGROUND: This study determined the histological features of the atrial myocardium connecting the coronary sinus and the left atrium in humans. METHODS AND RESULTS: Ten necropsied hearts were studied by performing serial longitudinal sections parallel to the long axis of the coronary sinus that extended its full length using a large microtome. In all specimens, the venous wall of the coronary sinus was surrounded by a cuff of striated muscle extending 40+/-8 mm from the ostium. Striated myocardial connections of varying number and morphology left this coronary muscle cuff and connected to the left atrium; they ranged from 1 to 2 fascicles to a widely intermingled continuum (thickness, 2.79+/-2 mm; width, 2.91+/-3.5 mm). These connections originated 8.8+/-5.7 mm from the coronary sinus ostium and inserted 18+/-11 mm distally into the left atrium. The insulating compartment in which the connections traversed between the left atrium and the coronary sinus was mostly formed of adipose tissue. The valve of Vieussens was found in 6 hearts at a mean distance of 3.4+/-3.2 mm from the distal extremity of the coronary sinus muscle cuff. CONCLUSIONS: In the human heart, a consistent but morphologically variable left atrial coronary sinus myocardial connection was found. This emphasizes the need for surgical dissection or catheter ablation in or around the coronary sinus to eliminate these connections.
Cite This Study
Chauvin et al. (2000) reported an observational. Histological analysis of 10 necropsied human hearts revealed consistent myocardial connections between the coronary sinus and left atrium, extending 40+/-8 mm from the ostium.