Three-dimensional visualisation of coronary sinus ostium from the inside right atrium perspective

BACKGROUND: There is no in vivo method of coronary sinus visualisation from the right atrium perspective. AIM: The objective of the study was to create a cardiac computed tomography (CT) angiography-based method of visualising the coronary sinus ostium and the Thebesian valve from the inside right atrium perspective. METHODS: In 78 consecutive patients, a cardiac CT angiography (Aquilion 64, Toshiba) with retrospective gating (slice 0.5 mm) was performed. Raw data were reconstructed on Vitrea 2 workstations (Vital Images). In order to create the three-dimensional (3D) coronary sinus visualisation from the "inside view" perspective, patented "Fly Through" algorithms were used, and the anatomical positions on the multiplanar reconstruction images were marked. A dedicated, Likert-based five-point scale was developed and used to evaluate the quality of the visualisations. RESULTS: The average quality of the visualisations of the coronary sinus ostium in two-dimensional multiplanar reconstruction images was good (4.17 ± 0.85 points) and was clinically interpretable in all cases. The image quality of the "inside view" 3D images was 3.61 ± 1.12 points. In 57.7% of cases we obtained high scores (4 and 5 points). The main diameter was 10.72 ± 2.48 mm, and the entrance angle of the coronary sinus into the right atrium was 103.76 ± 10.71°. CONCLUSIONS: Cardiac CT angiography is a useful method that permits the coronary sinus ostium and Thebesian valve to be visualised in vivo from the inside of the right atrium in a comparable manner.