Dissection of the coronary sinus during lead implantation for biventricular pacemaker implantation in patients with advanced heart failure is a serious complication that has occasionally been reported. We report on the clinical outcome and angiographic follow-up in a series of 7 patients with acute major dissection from 103 consecutive attempts (incidence 6.8%). Serial echocardiography was perf...

-----------------------------------.... Retrograde coronary sinus perfusion may provide equal if not better myocardial protection than antegrade cardioplegia during certain heart surgeries. The coronary venous system can be divided into the greater and lesser systems and veno-venous and arterio-venous anastomoses. Venous drainage varies greatly and retrograde coronary sinus perfusion depends on...

MANY excellent reviews of coronary arteriovenous fistulas have recently appeared in the literature.1 2 In the majority of these fatal cases, death was attributed to congestive heart failure. Rupture of the eoronary sinus as a coinplication of a coronary arteriovenous fistula has not, to our knowledge, been reported. The present case is thought to be unique in that the fistula was accompanied by...

Left ventricle-coronary sinus fistula and left ventricular pseudoaneurysm are unusual and frightening complications after mitral valve replacement. A 27-year-old female patient underwent mitral valve replacement 5 years previously and trans-thoracic echocardiography showed an outpouching lesion at the atrioventricular groove. It was difficult to differentiate whether the lesion was a left ventr...

Coronary artery ectasia is a rare angiographical finding, and it accounts for less than 5% of all coronary angiograms. We report a case of a 55-year-old male patient who presented with fatigue and exertional chest pain. Paraclinical tests revealed cardiac ischemia and sinus node dysfunction, as well as coronary artery ectasia without significant coronary stenosis. Factors involved in cardiac is...

Control of the coronary circulation by the carotid sinus was studied in intact, unanesthetized dogs instrumented with Doppler ultrasonic flow probes on the left circumflex coronary artery, miniature pressure gauges in the aorta, and stimulating electrodes on the carotid sinus nerves. A radiofrequency pacemaker was used to stimulate the nerves in dogs at rest, during sleep, exercise, and after a...

Background Increased coronary sinus (CS) pressure can reduce myocardial ischemia by redistribution of blood from nonischemic to ischemic territories. The Coronary Sinus Reducer is a percutaneous implantable device designed to establish CS narrowing and to elevate CS pressure. In preclinical experiments, implantation of the Reducer was safe and was associated with improved ischemic parameters. I...

Some of coronary artery anomalies, such as origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, represent a small amount of coronary anomalies. We describe a 63-year-old female patient which coronary angiogram revealed an origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, with significant atherosclerotic plaque at t...

A 65-year-old male was referred to our team after the incidental finding of a large non-coronary sinus of Valsalva aneurysm on computed tomography (CT)-scan of the thorax. Further imaging with transesophageal echocardiography (TOE) excluded intracardiac shunting. Unusually, the aneurysm had ruptured into the interatrial septum and was seen to be compressing both atria. At operative intervention...

The autoregulation of norepinephrine (NE) release mediated by presynaptic alpha and beta adrenoceptors on sympathetic nerve terminals in the heart of pentobarbital-anesthetized dog was studied. NE overflow elicited by left cardiac sympathetic nerve stimulation was determined from the coronary sinus blood, by using high-performance liquid chromatography with electrochemical detection. Intracoron...