Coronary sinus

Coronary Venous Anatomy Coronary venous flow occurs during diastole and systole, and the coronary venous system drains the myocardium of oxygen-depleted blood. The coronary venous system dominates the arterial system; there are at least twice as many veins as arteries in human myocardial tissue [1, 2]. In general, veins are considered to be "low-resistance conduits" to the heart and can alter their capacity to maintain venous pressure [3]. The coronary veins can be organized into 2 subgroups: the greater and smaller cardiac venous system. The greater cardiac venous system is comprised of the coronary sinus and its tributaries, as well as the anterior cardiac veins, atrial veins, and the veins of the ventricular septum [4, 5]. The smaller cardiac venous system, also known as the Thebesian vessels, is comprised of the arterioluminal vessels and venoluminal vessels [4-6], which are small vessels that drain directly into their respective heart chambers. This page focuses on the anatomy of the coronary sinus and its tributaries. 3D reconstruction of the coronary veins and cardiac tissue from a contrast-CT of a perfusion-fixed human heart. This is a left lateral view of the coronary sinus and its major tributaries. Some of these veins have varying nomenclatures present in the literature. The names highlighted in red are common in the literature, but are considered to be attitudinally incorrect. [4] Coronary Sinus The coronary sinus serves as the primary collector of cardiac veno...

An anomalous coronary artery wasn’t formed correctly in the womb. This rare problem means your coronary artery is in the wrong spot or it started in the wrong spot. This can cause problems with how your blood circulates through your heart. When your heart muscle doesn’t get the oxygen it needs, tissues can die. Overview Possible locations of anomalous coronary arteries. What is an anomalous coronary artery? An anomalous coronary artery wasn’t formed correctly before birth. In many cases, the coronary artery is in the wrong place or is coming from the wrong place. This problem can affect: • Right coronary artery. • Left coronary artery. • Left circumflex artery. • Left anterior descending artery. The problem with anomalous coronary arteries is that they aren’t where they’re supposed to be. They may start in: • The wrong part of your • Part of a different coronary artery. • Another artery. • The pulmonary artery. Types of coronary artery anomalies include: A common coronary artery anomaly is an artery coming out of the wrong aortic sinus of Valsalva. Normally, the right coronary artery comes out of the right aortic sinus of Valsalva. Similarly, the left coronary artery comes out of the left aortic sinus of Valsalva. A coronary artery that starts from the pulmonary artery instead of the aorta is another type of anomaly. This can affect the left or right coronary artery or (rarely) both. A rare form involves an accessory artery. In some cases, the normal coronary artery can ma...

Patients with severe refractory angina who are ineligible for revascularization recently gained expanded access to a new therapy option: implantation with a coronary sinus reducing device under the auspices of the COSIRA-II Investigational Device Exemption study launched earlier this year. The randomized trial is designed to enroll about 380 patients at up to 50 sites — including Cleveland Clinic —to investigate the safety and efficacy of the percutaneously delivered Neovasc Reducer™. The study is the largest sham-controlled device trial ever undertaken for coronary artery disease. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services The trial launch follows a period in which the investigational device was available in the U.S. solely on a compassionate-use basis, during which Cleveland Clinic implanted it in eight patients. “We have since begun enrolling patients in the COSIRA-II trial, with all subsequent implants performed according to trial protocol,” says interventional cardiologist Positive results from a phase 2 trial The first COSIRA study, New England Journal of Medicine, found that the coronary sinus reducing device led to significantly improved symptoms and quality of life. The phase 2 trial enrolled 140 patients with Canadian Cardiovascular Society class III or IV angina and myocardial ischemia who were not candidates for revascularization. Patien...

Article: • • • • • • Images: • Gross anatomy The coronary sinus courses along the posterior wall of the Veins draining into the coronary sinus are highly variable, but usually, include: • • • • • • Development The coronary sinus develops from one of the two sinus horns of the sinus venosum. The other horn becomes part of the right atrium. The right venous valve of the sinus venosum develops into the thebesian valve and the Variant anatomy • the coronary sinus may act as a conduit between a • rarely, the coronary sinus may drain into the left atrium, causing a left-to-right shunt (or right-to-left in cases of right heart failure) Related pathology The coronary sinus may be involved in a number of different procedures or pathologic processes: • the coronary sinus is a good position for lead placement in biventricular pacing • the coronary sinus may be an ablation target for some arrhythmia/dysrhythmias (e.g. • the coronary sinus rarely may have an abnormal connection to the left atrium on its way to the right atrium ( • associated with • 1. Fuster V, Walsh R, Harrington R. Hurst's the heart. McGraw-Hill Professional. ISBN:0071636463. • 2. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. Cambridge University Press. (2012) ISBN:0521766664. • 3. Last's anatomy, regional and applied. Churchill Livingstone. ISBN:044304662X. • 4. Moore KL, Agur AMR, Dalley AF. Clinically oriented anatomy. LWW. ISBN:1451119453. • 5. Shah SS, Teague SD, Lu JC, Dorfman AL, Kazerooni EA, ...

The coronary sinus is a collection of smaller veins that merge together to form the sinus (or large vessel), which is located along the heart’s posterior (rear) surface between the left ventricle and left atrium. The circumference of the vein is larger than average and is big enough to allow blood to be deposited by most veins that enter the heart. The coronary sinus collects the majority of the cardiac venous blood. It receives the blood from the myocardium, a thick layer of muscle within the heart, and facilitates the movement of the blood into the right atrium. The coronary sinus often serves as a landmark for surgeons who are performing cardiac surgery. It also plays an important role in many other heart procedures. For example, balloon catheters can safely be placed here to introduce contrasting agents and other therapeutics. For patients suffering from coronary artery disease, the coronary sinus an effective place to deliver cardioplegia to protect the myocardium from damage during surgery. Cardioplegia refers to the intentional, temporary cessation of heart activity (heartbeat) during cardiac surgery. Last medically reviewed on January 22, 2018

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