November 1, 1998Pacing and Clinical Electrophysiology
Angiographic Anatomy of the Coronary Sinus and Its Tributaries
Key result
Angiographic analysis of the coronary sinus and its tributaries revealed that the venous anatomy allows for the insertion of commercially available pacing leads in approximately 85% of cases.
Population
100 consecutive patients admitted for coronary angiography
Design
Cross-sectional
Authors
Discussion
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Implication
Supports anatomical feasibility of LV lead placement in most patients; leaves open translation to procedural success and outcomes.
Key Points
- Characterize the detailed angiographic anatomy, dimensions, and variations of coronary sinus tributaries to evaluate their suitability for permanent left ventricular pacing.
- Conducted simultaneous coronary venography in 100 consecutive patients undergoing coronary angiography via contrast injection into the left coronary artery.
- Analyzed the number, diameter, position, and angulation of cardiac veins across three radiographic projections (antero-posterior, LAO 60°, and RAO 30°) by three independent observers.
- The great cardiac vein (mean diameter 3.55 ± 1.24 mm) and middle cardiac vein (mean diameter 2.62 ± 1.26 mm) were consistently present in all patients.
- Left posterior veins (LPV) were variable in presence (0 to 3 veins) with a mean diameter of 2.25 ± 1.2 mm; absence, caliber < 2 mm, or severe angulation hindered venous access.
- Venous dimensions, tortuosity, and angulation permitted standard pacing lead placement in approximately 85% of cases.
Study Design
Type
Observational (n=100)
Structured PICO
P
Population
100 consecutive patients admitted for coronary angiography
I
Intervention
Simultaneous coronary venography after injection of 8 to 10 mL of contrast material into the left coronary artery
O
Outcome
Number, dimension, angulation, and position of the coronary sinus and of its tributariessurrogate
Anatomical variations in the coronary sinus and its tributaries allow for the insertion of commercially available left ventricular pacing leads in approximately 85% of patients.
Cite This Study
Gilard et al. (1998) conducted an observational in Patients admitted for coronary angiography (n=100). Coronary venography was evaluated on Anatomy (number, dimension, angulation, and position) of the coronary sinus and its tributaries. Angiographic analysis of the coronary sinus and its tributaries revealed that the venous anatomy allows for the insertion of commercially available pacing leads in approximately 85% of cases.