What is the coronary sinus? Could it be the same as having a sinus infection? Can there appear continuous symptoms like those that are caused by chronic sinusitis? Some of these questions are what runs through our mind. Only a doctor, pharmacist or biologists could provide you with the right answer. It not usually accompanied by pain in the eyebrow, dental pain or headache as in the case of a sinus infection. Thereby, it may require a specific treatment that can be different from those that are used for sinusitis, such as chronic sinusitis treatment.

So, what is the coronary sinus? It is a collection of vein found in both human beings and animals that comes together to form a massive vessel to gather blood from the myocardium of the heart.

Coronary Sinus Function

The function of coronary sinus is mainly to receive blood from the cardiac veins. It also collects blood from a vein in both the left posterior ventricular vein and the left marginal vein. The right atrium is directly supplied with blood from the anterior cardiac veins. These arteries help supply fresh blood to the heart. The coronary sinus functions generally as the major collector of cardiac venous blood.

Coronary Sinus Anatomy

The coronary sinus with sizes that varies from 15 to 65 mm in an adult can be found on the posterior surface of the heart. It directly empties blood into the right atrium close to the conjunction of the posterior coronary sulcus and the interventricular sulcus, found in-between the tricuspid valve and inferior vena cava. At the point where the right atrium joins the coronary sinus is the Thebesian valve which regulates the flow of blood into the heart. This Thebesian valve, which is sometimes referred to valve of the coronary sinus, usually takes the shape of a small fold of tissue making it possible for blood to go in one direction. This one way valve is of great importance to the heart as it helps prevent backflow and keep constant pressure within the circulatory system. The Thebesian valve guards the coronary sinus cavity.

Unroofed corornary sinus

Unroofed coronary sinus is an uncommon cardiac anomaly where there is communication between the left atrium and coronary sinus. This deficiency in the heart is greatly linked with left superior vena cava (LSVC) which drains blood directly into the coronary sinus. This can be classified into four groups which are:
type I, completely unroofed with LSVC;
type II, completely unroofed without LSVC;
type III, partial unroofed mid portion; and
type IV, partial unroofed terminal portion.
It is important to put into consideration the diagnosis of unroofed coronary sinus when examining patients with possible intra-cardiac shunts which causes right heart failure. Imaging with transoesophageal echocardiography and cardiac magnetic resonance has made possible the pre-operative diagnosis.

Dilated coronary sinus may occur in cases not necessarily anomalous in nature including right atrial hypertension or chronic congestive cardiac failure. If some of these causes are disregarded, thendilated coronary sinus may occur when there is an increase in the volume of flow of systemic venous blood collected by the sinus through anomalous communications. One of the causes of coronary sinus dilation is persistent left superior vena cava (LSVC), the commonest thoracic venous. The PSLVC is a rare vascular anomaly.
Various diagnosis of dilated coronary sinus include:
Persistence left superior vena cava
Any cause of high right atrial pressure
Coronary arterio-venous fistula

Minimally invasive cardiac surgery makes use of a variety of specialized cannulated catheters. The coronary sinus catheter is well known to be the most challenging among these catheters to place. There are various imaging strategies described to guidet he placement of the catheter. Transesophageal echocardiography(TEE) and fluoroscopy have both been used for guidance. The first challenge encountered when placing coronary sinus catheter is coming in contact with the coronary sinus ostium. The second challenge is advancing the coronary sinus catheter beyond the ostium as it can be hindered by obstruction.

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