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Background: Invasive cardiac procedures, such as arrhythmia ablation, cardiac resynchronisation therapy, percutaneous mitral annuloplasty and retrograde cardioplegia delivery require cannulation of the coronary sinus (CS). Detailed knowledge of the CS ostium region, including recognition of the presence of the Thebesian valve which sometimes covers the sinus, is a key to successfully carry out such procedures. Materials and methods: In the present study, 160 autopsied human hearts from both sexes were examined for the presence of the Thebesian valve. If identified, the histological structure of the valve was studied. Results: Five types of the CS valve were distinguished; all of them presented with a typical histological structure with the exception of the cord-like type, in which cells were similar to those of the conduction system of the heart. Conclusions: Proper identification of the CS valve and analysis of its size and histological features could have important implications for electrophysiologists. (Folia Morphol 2014; 73, 3: 298–301)
Background: The aim of the study was to perform qualitative and quantitative computed tomography (CT) angiography-based evaluation of patent ductus arteriosus (PDA) morphology and its influence on morphology of the great vessels. Materials and methods: Two-thousand twenty-two patients underwent 64-slice or dual-source CT and were retrospectively screened for the presence of PDA. Those who had presence of PDA underwent evaluation of its anatomy and morphology. Results: Thirty-two adult patients with PDA were evaluated (mean age 41.4 ± 17.4 years). Subjects with PDA had a higher value of aortic isthmus (p = 0.0148), main pulmonary artery (p < 0.0001), right (p =0.0007) and left (p = 0.0074) pulmonary arteries diameters than individuals from control group (16 adults, median age 43.3 ± 12.4 years). Types A, B, C, D, and E of PDA morphology occurred in 16 (50%), 3 (9%), 9 (28%), 2 (6%), and 2 (6%) patients, respectively. Subjects with the type A configuration of PDA tended to have a larger diameter at the aortic orifice (10.2 ± 5.2 mm vs. 6.4 ± 4.9 mm, p = 0.09) and a larger maximal diameter (10.3 ± 5.3 mm vs. 7.1 ± 4.7 mm, p = 0.14) compared to subjects with the type C configuration. The values of minimal, mean, and maximal diameters of PDA were 4.7 ± 1.9 mm, 7.0 ± 3.2 mm, and 9.4 ± 5.0 mm, respectively. The Spearman correlation coefficient between the main pulmonary artery and PDA diameters demonstrated a good correlation for minimal (r = 0.70, p < 0.001), mean (r = 0.62, p = 001), and maximal (r = 0.60, p = 0.0003) PDA diameters. Conclusions: Computed tomography enables quantitative and qualitative evaluation of PDA, including its type of morphology, length, and diameters. In the evaluated adult population with PDA, the majority of patients had dilation of the aortic isthmus and pulmonary arteries. PDA diameters correlate with diameters of the pulmonary arteries and this correlation is strongest between PDA diameter at the narrowest site and main pulmonary artery. (Folia Morphol 2020; 79, 3: 462–468)
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