The Prevalence of Coronary Sinus and Left Circumflex Artery Overlap in Relation to the Mitral Valve

Abstract

The prevalence of circumflex overlap between the coronary sinus and mitral valve was common across the sample size. The large variability in anatomy confirms the value of imaging individual patient cardiac anatomy prior to performing indirect percutaneous mitral valve annuloplasty to avoid impairment to the circumflex artery. This novel database can be utilized in the development of additional cardiac therapies that require access to the coronary sinus, such as therapeutic ablations.

Morphologic variability of the mitral valve leaflets

“…5 Relationships between the mitral annulus and the great cardiac vein, coronary sinus, or left circumflex coronary artery are substantial to minimize the occurrence of serious ischemic complications during percutaneous mitral valve interventions. 34 Knowledge of this is mandatory for percutaneous mitral annuloplasty through the coronary sinus. 35 There are described cases of left circumflex coronary artery occlusion during mitral valve surgery.…”

Multimodality imaging for preprocedural planning of percutaneous mitral valve repair: a comprehensive review

“…Mitral annulus anatomy as well as relationship with circumflex artery and coronary sinus should be evaluated to assess procedural feasibility and predict procedural success and complications, taking into account the high anatomical variability [45] .…”

Clinical anatomy of human heart atria and interatrial septum — anatomical basis for interventional cardiologists and electrocardiologists. Part 2: left atrium

“…Blood vessels may cross each other along their whole length at different levels, and this is the case for about 63-96% of patients. The percentage of overlap in posterior and left posterior regions of the heart is rather low (< 25%), while the crossing is most commonly encountered at the anterior margin of the mitral annulus [44]. The left circumflex artery passing beneath the coronary sinus poses the highest risk of artery occlusion caused by an annuloplasty device.…”