Department of Anatomy, SGT Medical College, Gurgaon, India.
Clin Anat. 2012 Apr;25(3):379-85. doi: 10.1002/ca.21236. Epub 2011 Aug 18.
Clinical cardiac procedures such as electrophysiology studies, catheter ablation of arrhythmias, retrograde cardioplegia delivery, cardiac resynchronization therapy and, more recently, percutaneous mitral annuloplasty, involve cannulation of the coronary sinus (CS). The presence of a membrane closing the orifice of the CS may cause difficulties during these interventions. Thus, detailed knowledge of the variations and anomalies of the valve of the CS, or the Thebesian valve, now has practical significance. To improve our understanding of this structure, classic anatomical dissection of 50 hearts from dissection room cadavers was performed. A Thebesian valve was present in the overwhelming majority (88%) of cases. Its morphology varied widely, from a few small strands of tissue, to a membrane covering more than half the CS ostium. A significant number (20%) of valves occluded >65% of the ostium, making them "potential complicating factors" in cannulation of the CS. An understanding of these anatomical variations may help in identifying and overcoming potential difficulties during clinical cardiac interventions.
临床心脏手术，如电生理研究、心律失常导管消融、逆行心脏停搏液灌注、心脏再同步治疗，以及最近的经皮二尖瓣环成形术，都涉及到冠状窦（CS）的插管。在这些介入过程中，封闭 CS 口的膜可能会引起困难。因此，对 CS 瓣或 Thebesian 瓣的变异和异常的详细了解现在具有实际意义。为了提高我们对这种结构的理解，对来自解剖室尸体的 50 个心脏进行了经典解剖。在绝大多数（88%）病例中存在 Thebesian 瓣。其形态变化很大，从少数小束组织到覆盖 CS 口一半以上的膜。相当数量（20%）的瓣口阻塞超过 65%的口，使它们成为 CS 插管的“潜在并发症因素”。了解这些解剖学变异可能有助于在临床心脏介入过程中识别和克服潜在的困难。
