Morphological and Clinical Significance of Thebesian Valve Guarding Ostium of Coronary Sinus
28 June 2019 (eFirst)
Background The advent of novel therapeutic techniques require cannulation of coronary sinus. The Thebesian valve guarding the ostium of coronary sinus can pose practical difficulties during such procedures.
Aim With this background we undertook a detailed study of the morphological features of Thebesian valve, so that we can substantially evaluate the clinicoanatomical importance of it.
Materials and Methods Fifty human dissected cadaveric heart specimens were selected from the department of anatomy, SDM College of Medical Sciences and Hospital, Dharwad. The location of ostium of coronary sinus and the occurrence of the Thebesian valve and its shape, composition, and extent of occlusion of the ostium were carefully observed and noted.
Results Our observations revealed that 90% of specimens had the Thebesian valve guarding the opening of coronary sinus. It was semilunar in shape in 74% of specimens. The valve was membranous in composition in 46% of specimens. Among these, in 26% of specimens the valve almost covered more than 50% of the ostium of coronary sinus indicating moderate to severe occlusion.
- 1 Loukas M, Clarke P, Tubbs RS, Kolbinger W. Adam Christian Thebesius, a historical perspective. Int J Cardiol 2008; 129 (01) 138-140
- 2 Kautzner J. Thebesian valve: the guard dog of the coronary sinus?. Europace 2009; 11 (09) 1136-1137
- 3 Mak GS, Hill AJ, Moisiuc F, Krishnan SC. Variations in Thebesian valve anatomy and coronary sinus ostium: implications for invasive electrophysiology procedures. Europace 2009; 11 (09) 1188-1192
- 4 Pejković B, Krajnc I, Anderhuber F, Kosutić D. Anatomical variations of the coronary sinus ostium area of the human heart. J Int Med Res 2008; 36 (02) 314-321
- 5 Randhawa A, Saini A, Aggarwal A, Rohit MK, Sahni D. Variance in coronary venous anatomy: a critical determinant in optimal candidate selection for cardiac resynchronization therapy. Pacing Clin Electrophysiol 2013; 36 (01) 94-102
- 6 Mlynarski R, Sosnowski M, Wlodyka A, Kargul W, Tendera M. A user-friendly method of cardiac venous system visualization in 64-slice computed tomography. Pacing Clin Electrophysiol 2009; 32 (03) 323-329
- 7 Scholten MF, Szili-Torok T, Thornton AS, Roelandt JRTC, Jordaens LJ. Visualization of a coronary sinus valve using intracardiac echocardiography. Eur J Echocardiogr 2004; 5 (01) 93-96
- 8 Katti K, Patil NP. The Thebesian valve: gatekeeper to the coronary sinus. Clin Anat 2012; 25 (03) 379-385
- 9 Ghosh SK, Raheja S, Tuli A. Obstructive Thebesian valve: anatomical study and implications for invasive cardiologic procedures. Anat Sci Int 2014; 89 (02) 85-94
- 10 Pagel PS, De Vry DJ, Overturf AM, Rashid ZA. Unusual flap-like linear echogenic structure in the posterior right atrium above the tricuspid valve septal leaflet. J Cardiothorac Vasc Anesth 2016; 30 (01) 266-268