It then curves to the left in the coronary sulcus, and reaching the back of the heart, opens into the left extremity of the coronary sinus, draining from the myocardium.
22.
Clevidipine is a dihydropyridine L-type calcium channel blocker, highly selective for lactate production in coronary sinus blood has been seen, confirming the absence of myocardial ischemia due to coronary steal.
23.
The valve of the coronary sinus is on the posterior, inferior surface of the heart, medial to the inferior vena cava opening, just superior to the septal leaflet of the tricuspid valve.
24.
Mohl invented Pressure-controlled intermittent coronary sinus occlusion ( also known as PICSO ), a procedure utilized to enhance restoration of blood flow to the microcirculation in heart tissue following a myocardial infarction.
25.
Since blood moves from areas of high pressure to areas of low pressure, when the chambers are relaxed, blood will flow into the atria ( through the coronary sinus and the pulmonary veins ).
26.
Thebesian veins have been successfully identified by following the route of contrast flow-during catheterization procedures-from the subendocardium, through the thebesian veins, into larger veins, and into the coronary sinus.
27.
The left portion shrinks in size and eventually forms the coronary sinus ( right atrium ) and oblique vein of the left atrium, whereas the right part becomes incorporated into the right atrium to form the sinus venarum.
28.
The cause of the arrhythmia, the ectopic focus, is usually near the AV node in the triangle of Koch ( a rough triangle with points at the coronary sinus, the tendon of Todaro, and the tricuspid valve ).
29.
In summary, it would appear that placing the following lesions can cure most patients with atrial fibrillation of either type : pulmonary vein encircling incision, left atrial isthmus lesion with its attendant coronary sinus lesion, and the right atrial isthmus lesion.
30.
The assumption that a low mixed venous oxygen saturation ( normal = 60 % except for the coronary sinus where it approximates 40 % reflecting the high metabolic rate of the myocardium ) represents less than adequate oxygen delivery is consistent with physiological and metabolic observations.
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