Abstract 15003: Prevalence of Coronary Sinus and Left Circumflex Artery Overlap: Considerations for Percutaneous Treatment of Mitral Regurgitation
Background: Treatment of mitral valve regurgitation using an indirect percutaneous approach through the coronary sinus has been under development. Therefore, detailed characterization of where the circumflex artery tends to cross between the coronary sinus and the mitral valve is important for the prevention of serious arterial complications.
Methods: Magnetic resonance images were obtained for 65 perfusion-fixed human hearts. Using Mimics Software (Materlise, Leuven, Belgium), reconstructions of the anatomical orientations of the coronary sinus, circumflex artery, and mitral valve annulus were generated. The prevalence and location of sites where the circumflex artery coursed between the coronary sinus and mitral valve were assessed.
Results: Overall, the circumflex coursed between the coronary sinus and mitral valve in 88% of specimens. The figure depicts where these overlaps most often occurred. More specifically, the figure shows the percentage of specimens with an overlap in specific anatomical regions of the mitral valve. In addition, the coronary sinus did not lie in the plane of the mitral annulus in roughly 20% of the hearts in this study.
Conclusions: In general, overlaps between the circumflex artery and coronary sinus are less prevalent more proximal to the coronary sinus ostium. This suggests considerations for the development of an annuloplasty device that would be delivered in the proximal region of the coronary sinus. The results of this study also stress the importance of imaging individual patient cardiac anatomy before performing indirect percutaneous mitral valve annuloplasty to avoid impairment to the circumflex artery.
- © 2013 by American Heart Association, Inc.