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2001 | 60 | 4 |

Tytuł artykułu

The middle cardiac vein as a key for 'posteroseptal' space - a morphological point of view

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
About 25% of accessory pathways (AP) run via “posteroseptal” space (PSS). There are three approaches for ablation of these pathways: from the right atrium, from the left atrium or from the ventricle and coronary sinus (CS). However in some cases AP is too far from all of them. Catheterisation of the middle cardiac vein (MCV) seems to be the only chance for successful ablation. Our aim was to evaluate the topography of the MCV in PSS. Classical anatomical investigation was carried out on the autopsy material of 98 consecutive human hearts (42 F, 56 M; age 57 ± 21 yrs). It was supported by transverse section performed under coronary sinus. Regions just behind the atrioventricular septum and behind the cavities were respectively classified as “septal”, right (RP) and left posterior (LP). Between them right (RPS) and left posteroseptal areas (LPS) were present. At the posterior view of the heart the angle between CS and MCV ranged from 75 to 90° in 62% of hearts, 60–75° in 18%, 30–60° in 10% and 90–130° in 10%. In 16% MCV ran via the “septal” region, 59% — LPS, 10% — RPS, 10% — RP and 5% — LP. At the ostium of 58% MCV a valve was observed, however there was no trouble with insertion of the 6F catheter into it. We concluded that it is possible to insert the 6F catheter into MCV, which makes it possible to perform ablation of epicardial postero-inferior accessory pathways. The origin of MCV is usually located in the left “posteroseptal” region and runs towards the left side of the posterior wall.

Słowa kluczowe

Wydawca

-

Czasopismo

Rocznik

Tom

60

Numer

4

Opis fizyczny

p.293-296,fig.,ref.

Twórcy

autor
  • Medical University of Gdansk, Kieturakisa 1, 80-742 Gdansk, Poland
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Bibliografia

  • 1. Arruda M, Wang X, McClelland J (1992) ECG algorithm for predicting radiofrequency ablation site in posteroseptal accessory pathways. Pacin Clin Electrophysiol, 15: 535 Abstr.
  • 2. Dean JW, Ho SY, Rowland E, Anderson R (1994) Clinical Anatomy of the Atrioventricular Junctions. J Am Coll Cardiol, 24 (7): 1725–1731.
  • 3. Jackman WM, Wang X, Friday KJ, Zipes DP, Nacarelli GV, Lazarra R (1991) Catheter ablation of accessory AV pathways (Wolff-Parkinson-White syndrome) by radiofrequency current. N Engl J Med, 324: 1605–1611.
  • 4. Jedynak Z, Walczak F, Koźluk E, Kępski R, Szufladowicz E, Rembelska H (1997) Szlak tylno-dolny (vena cordis media) — charakterystyka i miejsce ablacji. ESS, 4: 149 Abstr.
  • 5. Langberg JJ, Ching Man K, Vorperian VR, Calcins H, Morady F (1993) Recognitation and catheter ablation of subepicardial accessory pathways. J Am Coll Cardiol, 22: 1100–1104.
  • 6. Omran H, Pfeiffer D, Tebbenjohanns J (1995) Echocardiographic imaging of coronary sinus diverticula and middle cardiac veins in patients with preexcitation syndrome: impact on radiofrequency catheter ablation of posteroseptal accessory pathways. PACE, 18: 1236–1243.
  • 7. Schluter M, Kuck KH (1992) Die Katheterablation von septalen akzessorischen Leitungsbahnen mit Hochfrequenzstrom. Z Kardiol, 81: 249–257.
  • 8. Schumacher B, Tebbenjohanns J, Pfeiffer D (1995) Prospective study of retrograde coronary venography in patients with posteroseptal and left sided accessory atrioventricular pathways. Am Heart J, 130: 1031–1039
  • 9. Walczak F, Jedynak Z, Koźluk E, Kepski R, Marcisz-Szufladowicz E, Łastowiecka E, Stępińska J, Popławska W, Bujnowska E (1995) Importance of morphology during atrio-ventricular tachycardia in accessory pathway localisation. In: “EuroPace’95”, Monduzzi Editore, International Proceedings Division. Bologna 203–206.
  • 10. Walczak F, Jedynak Z, Koźluk E, Kępski R, Szufladowicz E, Rembelska H (1996) Miejsce skutecznej ablacji dodatkowego szlaku przewodzenia przedsionkowo-komorowego. Kard Pol, 45 (Suppl. I): 298 Abstr.

Typ dokumentu

Bibliografia

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Identyfikator YADDA

bwmeta1.element.agro-article-470886b5-171c-4358-aacf-fac505d86c27
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