open access

Vol 60, No 4 (2001)
ORIGINAL ARTICLES
Published online: 2001-08-10
Submitted: 2012-02-06
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The middle cardiac vein as a key ”posteroseptal” space - morphological point of view

Dariusz Kozłowski, Edward Koźluk, Agnieszka Piątkowska, Hubert Maruszak, Marcin Gawrysiak, Marek Grzybiak, Franciszek Walczak
Folia Morphol 2001;60(4):293-296.

open access

Vol 60, No 4 (2001)
ORIGINAL ARTICLES
Published online: 2001-08-10
Submitted: 2012-02-06

Abstract

About 25% of accessory pathways (AP) run via “posteroseptal” space (PSS). There are three approaches for ablation of these pathways: from the right atrium, from the left atrium or from the ventricle and coronary sinus (CS). However in some cases AP is too far from all of them. Catheterisation of the middle cardiac vein (MCV) seems to be the only chance for successful ablation. Our aim was to evaluate the topography of the MCV in PSS. Classical anatomical investigation was carried out on the autopsy material of 98 consecutive human hearts (42 F, 56 M; age 57 ± 21 yrs). It was supported by transverse section performed under coronary sinus. Regions just behind the atrioventricular septum and behind the cavities were respectively classified as “septal”, right (RP) and left posterior (LP). Between them right (RPS) and left posteroseptal areas (LPS) were present. At the posterior view of the heart the angle between CS and MCV ranged from 75 to 90° in 62% of hearts, 60-75° in 18%, 30-60° in 10% and 90-130° in 10%. In 16% MCV ran via the “septal” region, 59% - LPS, 10% - RPS, 10% - RP and 5% - LP. At the ostium of 58% MCV a valve was observed, however there was no trouble with insertion of the 6F catheter into it. We concluded that it is possible to insert the 6F catheter into MCV, which makes it possible to perform ablation of epicardial postero-inferior accessory pathways. The origin of MCV is usually located in the left “posteroseptal” region and runs towards the left side of the posterior wall.

Abstract

About 25% of accessory pathways (AP) run via “posteroseptal” space (PSS). There are three approaches for ablation of these pathways: from the right atrium, from the left atrium or from the ventricle and coronary sinus (CS). However in some cases AP is too far from all of them. Catheterisation of the middle cardiac vein (MCV) seems to be the only chance for successful ablation. Our aim was to evaluate the topography of the MCV in PSS. Classical anatomical investigation was carried out on the autopsy material of 98 consecutive human hearts (42 F, 56 M; age 57 ± 21 yrs). It was supported by transverse section performed under coronary sinus. Regions just behind the atrioventricular septum and behind the cavities were respectively classified as “septal”, right (RP) and left posterior (LP). Between them right (RPS) and left posteroseptal areas (LPS) were present. At the posterior view of the heart the angle between CS and MCV ranged from 75 to 90° in 62% of hearts, 60-75° in 18%, 30-60° in 10% and 90-130° in 10%. In 16% MCV ran via the “septal” region, 59% - LPS, 10% - RPS, 10% - RP and 5% - LP. At the ostium of 58% MCV a valve was observed, however there was no trouble with insertion of the 6F catheter into it. We concluded that it is possible to insert the 6F catheter into MCV, which makes it possible to perform ablation of epicardial postero-inferior accessory pathways. The origin of MCV is usually located in the left “posteroseptal” region and runs towards the left side of the posterior wall.
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Keywords

accessory pathways; coronary sinus; middle cardiac vein; posteroseptal space; radiofrequency ablation

About this article
Title

The middle cardiac vein as a key ”posteroseptal” space - morphological point of view

Journal

Folia Morphologica

Issue

Vol 60, No 4 (2001)

Pages

293-296

Published online

2001-08-10

Bibliographic record

Folia Morphol 2001;60(4):293-296.

Keywords

accessory pathways
coronary sinus
middle cardiac vein
posteroseptal space
radiofrequency ablation

Authors

Dariusz Kozłowski
Edward Koźluk
Agnieszka Piątkowska
Hubert Maruszak
Marcin Gawrysiak
Marek Grzybiak
Franciszek Walczak

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