Another issue that can happen is that the other coronary veins
and arteries are not properly formed, so this can lead to a decrease of blood, or blood going to the wrong areas of the body.
The main limitations of percutaneous techniques for MVR using the transcoronary venous approach are the variability in coronary venous anatomy, the presence of venous valves within the coronary veins
, and the variability of the crossing point of the great cardiac vein and circumflex artery.
Despite this adjustment, veins other than the proximal coronary veins (the CS, middle cardiac vein, small cardiac vein, and posterior vein) were not visualized optimally.
No other congenital abnormality was identified during this CTA examination such as abnormal coronary vein drainage into the left atrium or an atrial septal defect.
The operators sometimes confront limitations to implant left ventricular lead in coronary veins. These include unsuitable branching angle of coronary veins and tortuosity of coronary sinus anatomy, postoperative deformation, presence of venous valves, absence of vessel in target location, and coronary venous stenosis (2, 3).
During the procedure, guiding catheter was engaged into the coronary sinus ostium, and coronary venography was undertaken to choose target coronary vein for left ventricular lead insertion.
: These veins shuttle blood and harmful waste products away from the heart.
No matter how badly diseased a patient's coronary arteries are, the coronary veins remain disease free.
And particularly on the left side of the heart, the coronary veins parallel the major epicardial arteries.
The blood is then returned to the right atrium through the coronary sinus, a large vein formed by the coronary Veins
The reasons for difficult LV lead implantations are coronary venous system related issues (failure to access coronary venous system and anatomic variations in the coronary veins
), extensive scar tissue in the target region for LV pacing, phrenic nerve stimulation, and LV lead instability.
The diameter of the CS is also variable and is dependent on the loading conditions, presence and extent of atrial myocardium with the coronary vein
. At the level of the A-V sulcus, the anterior surface of the CS is separated from the atrial and ventricular myocardium by connective and adipose tissue, precluding it from an intramural location in the atrioventricular sulcus.