MT: Coronary Sinus
MD: Definition and function of the coronary sinus, including the defects and treatments.
Coronary Sinus is a vein found at the posterior region of the heart, between the left ventricle and left atrium. The vein is relatively large compared to other veins, carrying deoxygenated blood from different epicardial veins into the right atrium of the heart.
These veins include the Great Cardiac Vein which collects from the ventricles and the left atrium, the Oblique Vein of the left atrium which is a tiny vessel, the left Marginal vein that receives blood from the left atrium and the ventricles and other Arterial veins found in the interventricular and the left ventricle.
The coronary sinus is present in all mammals including humans; it is quite short in length and may vary from person to person, usually within the range of about 15-65mm in adults.
Coronary Sinus Function
The main function of the coronary sinus is to collects Cardiac Venous blood. It carries blood from the myocardium and allows blood to flow into the right atrium. It is also important in cardiac surgery. It acts as a marker for those carrying out surgery.
Some defects affecting the coronary sinus include Unroofed Coronary Sinus (UCS). This defect brings about an abnormal flow between the coronary Sinus and the left atrium. UCS is closely related to Persistent Left Superior Vena Cava which is known as PLSVC. It can result in failure of the heart if it is not rectified. To treat Unroofed Coronary Sinus, surgery is usually performed on the patient. The systemic venous drainage is separated from the pulmonary venous drainage.
A second coronary Sinus defect is the dilation of the coronary sinus. This defect is found mainly in people suffering from pulmonary hypertension without structural disease of the tricuspid valve. It has also been observed that coronary sinus dilation can be found in patients with congestive heart failure and venous congestion.
Coronary Sinus Catheterization is used to help drain the cardiac venous blood. This method can be used to treat defects of the coronary sinus. But placing the catheter can be risky especially for elderly patients and very young patients. Access to the coronary sinus can be made by combining two systems and they are the steerable electrophysiology catheter and telescoping inner catheter. But for those with seriously dilated coronary sinus, surgery is recommended.
Other treatments that does not require surgery includes the Anticongestive therapy and the Antiarrhythmic therapy.