Letter in response to the original article: “Evaluation of femoral approach to coronary sinus...

Letter in response to the original article: ‘‘Evaluation of femoral approach to coronary sinus catheterisation in electrophysiological and ablation procedures: Single centre experience’’ authored by Osama Abdel Atty, Mohamed Morsy and Mark M. Gallagher (Journal of the Saudi Heart Association, Volume 23, Issue 4, October 2011, pp. 213–216) To the Editor, T he authors present data from their centre regarding cannulating the coronary sinus by the femoral venous approach. As the author cor- rectly points out, this approach has become increasingly feasible with the use of long sheaths such as the Swartz SL3 sheath (Daig Corp., Min- netonka, MN, USA) as has been previously dem- onstrated [1]. Lack of success in cannulating the coronary sinus is largely operator-dependent and the curve of the diagnostic catheter selected; use of appro- priate views, such as an optimum right anterior oblique view for identifying the atrio-ventricular plane/target coronary sinus os region and the orthogonal left anterior oblique view for gauging the depth of cannulation, help signiﬁcantly. The anatomy varies from person-to-person which adds to the problem; this especially is the case when there is enlargement of the cardiac cham- bers or a more horizontal lie of the coronary sinus. In these instances a sheath such as the one described earlier is very useful. The same sheath could be used for contrast injection to delineate the coronary sinus (a diagnostic EP catheter with a lumen may also be used instead). In order to assess the success of coronary sinus cannulation accurately, details about additional manoeuvres performed will be helpful. References [1] Pepper CB, Davidson NC, Ross DL. Use of a long preshaped sheath to facilitate cannulation of the coronary sinus at electrophysiologic study. J Cardiovasc Electrophysiol 2001;12(12):1335–7. David Chase Department of Cardiac Electrophysiology and Pacing, Christian Medical College Hospital, Vellore, Tamil Nadu, India Tel.: +91 4162283572; fax: +91 4162232035 E-mail address: [email protected] P.O. Box 2925 Riyadh – 11461KSA Tel: +966 1 2520088 ext 40151 Fax: +966 1 2520718 Email: [email protected] URL: www.sha.org.sa LETTER TO THE EDITOR Received 28 October 2011; accepted 1 January 2012. Available online 10 January 2012 1016–7315 Ó 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. Peer review under responsibility of King Saud University. URL: www.ksu.edu.sa doi:10.1016/j.jsha.2012.01.001

Upload
david-chase
Category

Documents
view
213
download
1

Embed Size (px):

Transcript of Letter in response to the original article: “Evaluation of femoral approach to coronary sinus...

P.O. Box 2925 Riyadh – 11461KSATel: +966 1 2520088 ext 40151Fax: +966 1 2520718Email: [email protected]: www.sha.org.sa

LETT

ER T

O T

EDIT

Received 28 October 2011; accepted 1 January 2012.Available online 10 January 2012

To the Editor,

The authors present data from their centreregarding cannulating the coronary sinus by

the femoral venous approach. As the author cor-rectly points out, this approach has becomeincreasingly feasible with the use of long sheathssuch as the Swartz SL3 sheath (Daig Corp., Min-netonka, MN, USA) as has been previously dem-onstrated [1].

Lack of success in cannulating the coronarysinus is largely operator-dependent and the curveof the diagnostic catheter selected; use of appro-priate views, such as an optimum right anterioroblique view for identifying the atrio-ventricularplane/target coronary sinus os region and theorthogonal left anterior oblique view for gaugingthe depth of cannulation, help significantly. Theanatomy varies from person-to-person whichadds to the problem; this especially is the casewhen there is enlargement of the cardiac cham-bers or a more horizontal lie of the coronary sinus.In these instances a sheath such as the one

1016–7315 � 2012 King Saud University.

Peer review under responsibility of King Saud University.

URL: www.ksu.edu.sa

doi:10.1016/j.jsha.2012.01.001

described earlier is very useful. The same sheathcould be used for contrast injection to delineatethe coronary sinus (a diagnostic EP catheter witha lumen may also be used instead).

In order to assess the success of coronary sinuscannulation accurately, details about additionalmanoeuvres performed will be helpful.

References

[1] Pepper CB, Davidson NC, Ross DL. Use of a longpreshaped sheath to facilitate cannulation of the coronarysinus at electrophysiologic study. J CardiovascElectrophysiol 2001;12(12):1335–7.

David ChaseDepartment of Cardiac Electrophysiology and Pacing,

Christian Medical College Hospital, Vellore,Tamil Nadu, India

Tel.: +91 4162283572; fax: +91 4162232035E-mail address: [email protected]

http://dx.doi.org/10.1016/j.jsha.2012.01.001