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Heart Failure in Adult Congenital Heart Disease
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Andrew Constantine, Ana Barradas-Pires, Isma Rafiq, Justyna Rybicka, Michael A. Gatzoulis, Konstantinos Dimopoulos
Cardiac resynchronization therapy (CRT) is recommended for patients with acquired HF on optimal medical therapy, based on symptoms, systemic ventricular function, evidence of electrical dyssynchrony, and the absence of atrial fibrillation.95 In this population, there is mounting evidence of improvements in exercise capacity, quality of life, ventricular function, and survival.96,97 CRT placement, particularly when an ICD is being planned, may provide additional benefit to some ACHD patients, but strong evidence is lacking. Access to the coronary sinus or one of its ventricular branches may be hampered or precluded by anomalous position of the coronary sinus, or previous surgery.
Systemic Veins of the Thorax.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Anatomically, the coronary sinus lies in the left atrio-ventricular groove on the posterior aspect of the heart. Superiorly it begins as a continuation of the great cardiac vein, then descends vertically receiving blood from cardiac veins, turns horizontally and after passing anterior to the I VC empties into the right atrium.
Relation Between Contraction and Metabolic Efficiency
Published in Samuel Sideman, Rafael Beyar, Analysis and Simulation of the Cardiac System — Ischemia, 2020
Joseph Kedem, M. Scheinowitz, E. Furman, J. Sonn, H. R. Weiss
Left ventricular oxygen consumption (MVO2) was measured at various heart rates as the product of coronary sinus blood flow and the difference (in volume percent) of O2 content between arterial and coronary sinus venous blood samples. Coronary venous flow was measured using a specially designed wide-bore L-shaped glass cannula that was inserted into the coronary sinus via an opening in the right atrium. Before insertion of the cannula, the animal was completely heparinized (8550 IU). Coronary sinus blood was collected through a latex tube and warmed in a reservoir maintained at 37 °C by a water bath. The blood was reinfused with the aid of a peristaltic pump (Manostat®) through the catheter in the femoral vein. Blood was pumped back to the animal at the same rate as it left the coronary sinus. The coronary flow was determined by measuring the time required for 10 ml of blood to flow out of the coronary sinus. Blood samples were taken through a needle inserted in the latex tubing as close as possible to the heart.
Coronary Sinus Defect, Premature Restriction of Foramen Ovale and Cysto-Colic Peritoneal Band
Published in Fetal and Pediatric Pathology, 2023
The coronary sinus is formed by coalescence of venous tributaries comprised of a small, middle, great, and oblique cardiac vein; the left marginal vein; and the left posterior ventricular vein [5,6]. Together with the vena cavae (superior and inferior), the coronary sinus delivers deoxygenated blood to the right atrium [6]. Unroofed coronary sinus is a congenital cardiac anomaly first described by Raghib et al [1]. There is an overwhelming association of this anomaly with persistent left superior vena cava that drains the left internal jugular and subclavian veins into the coronary sinus [7]. A persistent left superior vena cava occurs in 0.1–0.5% of the general population, with 8% draining into the left atrium [2]. The morphologic type of unroofed coronary sinus have been classified as Kirklin and Barratt-Boyes types whereby (1) type I is completely unroofed with persistent left superior vena cava; (2) type II is completely unroofed but without persistent left superior vena cava; (3) type III shows partially unroofed midportion; and (4) type IV shows partially unroofed terminal portion [2,8,9].
Is combined use of radiofrequency ablation and balloon dilation the future of interatrial communications?
Published in Expert Review of Cardiovascular Therapy, 2022
In contrast to these specialty devices, the Edwards shunt device creates an interatrial communication between the left atrium and coronary sinus. It is a bare-nitinol implant with four arms, and the internal shunting diameter is 7 mm. Since access is gained through the right internal jugular vein, the procedure seems more complex, and implantation was successful in eight of eleven patients in the first in-human study [19]. Although the device might prevent paradoxical embolism or atrial arrhythmias, improvements can be made to prevent related risks associated with the large delivery sheath (24 F). Several potential complications are associated with coronary sinus cannulation and coronary sinus-to-left atrial puncture. Even after successful device implantation, the potential risks, such as an obstruction or stenosis of the coronary sinus, should be monitored.
Real world data on non-complex catheter ablations performed on zero fluoroscopy in a secondary centre in the south of Belgium
Published in Acta Cardiologica, 2021
Lucio Capulzini, Christophe de Terwangne, Gianbattista Chierchia, Carlo de Asmundis, Gaetano Paparella, Antonio Sorgente
Table 1 shows their demographic and clinical characteristics. Table 2 shows the procedural characteristics. Right atrial flutters and typical atrioventricular nodal re-entry tachycardia (AVNRT) were the most common arrhythmia treated, corresponding together to the 81% of the total. Two patients demonstrated to be affected by orthodromic AVRT through a manifest right mid-septal and a concealed left lateral atrio-ventricular accessory pathway, respectively. Three patients underwent uneventfully catheter ablation of a PVC originating respectively from the anteroseptal free wall (2) and postero-septal aspect of the right ventricular outflow tract (RVOT). Right femoral access was obtained in 86% of cases with left femoral access used in the remaining when right femoral access was not successful after the third attempt. Coronary sinus cannulation was efficacious within 10 min in 76% of cases.