Anatomical peculiarities of the cavo-tricuspid isthmus in the human heart

Abstract

The cavo-tricuspid isthmus is the term for the part of the right atrium between the ostium of the inferior vena cava and its border--the Eustachian ridge on one side and the tricuspid valve on the other side. In this area lie the coronary sinus ostium with its Thebesian valve, the fibers of Chiari (10%), and ostia of the deep cardiac veins--the Thebesian veins in close relation to the coronary sinus ostium (35%). Pacing of the coronary sinus is very often used during the treatment of cardiac arrhythmias; radiofrequency catheter ablation in cases of permanent atrial tachycardia is successfully performed through the coronary sinus; during certain cardiosurgical procedures, cardioplegia is performed by retrograde perfusion of the myocardium through the coronary sinus. Knowing and recognizing certain anatomical peculiarities of the structures in this part of the right atrium may be interesting for clinical practice.

Clinical Anatomy of the Cavotricuspid Isthmus and Terminal Crest

“…There have only been three anatomical studies that have comprehensively investigated the majority of CTI dimensions [ 4 , 6 , 7 ]. Pejkovic and Krajnc as well as Gami et al have investigated precisely the CTI region, but these authors did not measure the major CTI dimensions [ 9 , 13 ]. Table 4 presents a comparison our results with those of previous studies.…”

Clinical experience with routine use of a single combined mapping and ablation catheter for isolation of pulmonary veins in patients with paroxysmal atrial fibrillation

“…Comparable with other anatomic peculiarities of the atria, such as the cavo-tricuspid isthmus, the incidence of additional PVs or of common PV ostia can be expected in about 25% [21,22]. In our patient cohort, the percentage of patients allocated to the control group (41%) was higher because of 12 additional patients with an ostial PV diameter > 25 mm.…”