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The Coronary Vascular System and Associated Medical Devices

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Handbook of Cardiac Anatomy, Physiology, and Devices

Abstract

Even as recent as several hundred years ago, the general function of the coronary vascular system was largely unknown. Today, it is well established that the coronary system is a highly variable network of both arteries supplying and veins draining the myocardium of oxygenated and deoxygenated blood, respectively. Due to recent advances in therapeutic technologies, the coronary vascular system has been utilized as a conduit in a variety of biomedical applications, e.g., cardiac resynchronization therapy. Additionally, symptomatic diseases such as coronary artery disease can be alleviated with stenting or coronary artery bypass grafts. It is well accepted that a comprehensive understanding of the geometric anatomical characteristics of the coronary system will allow for future medical devices to be engineered to more successfully deliver novel therapies to a greater variety of cardiac patients.

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Authors and Affiliations

  1. Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, 55455, USA

    Julianne H. Spencer PhD, Sara E. Anderson PhD & Paul A. Iaizzo PhD

  2. Department of Surgery, University of Minnesota, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN, 55455, USA

    Julianne H. Spencer PhD, Sara E. Anderson PhD & Paul A. Iaizzo PhD

  3. Medtronic, Inc., 8200 Coral Sea Street NE, Mounds View, Minneapolis, MN, 55112, USA

    Julianne H. Spencer PhD & Ryan Lahm MS

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  1. Julianne H. Spencer PhD
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  2. Sara E. Anderson PhD
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  3. Ryan Lahm MS
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  4. Paul A. Iaizzo PhD
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Correspondence to Julianne H. Spencer PhD .

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  1. B172 Mayo, MMC 195, University of Minnesota Department of Surgery, Minneapolis, Minnesota, USA

    Paul A. Iaizzo

1 Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Movie 8.1. This movie illustrates a semitransparent heart as it rotates about its vertical axis. The path of the coronary sinus is highlighted during the first portion of the movie. The three leads implanted during cardiac resynchronization therapy are shown and labeled (MPEG 4,511 KB)

Movie 8.2. This movie is an example of a valve covering a venous contributor ostia (MPEG 860 KB)

Movie 8.3. This movie shows a venogram in an isolated heart. It illustrates a catheter cannulating the coronary sinus ostium, then switches to a fluoroscopic view of the heart, where the coronary veins become opaque as a contrast agent is injected (MPEG 7,187 KB)

145597_3_En_8_MOESM4_ESM.avi

Movie 8.4. Stent implantation procedure. A guide wire is delivered through the left coronary ostium to the LAD. A CordisBx Velocity Rx® balloon expandable stent (4.0 mm inner diameter, 23 mm length) is then advanced over the guide wire. The stent is deployed by inflating the balloon to the manufacturer’s recommended pressure. The catheter is removed and the fiberscope, which is positioned distal to the stent, is advanced retrograde through the stent. Three-dimensional anatomical reconstructions using contrast-computed tomography scans and MIMICs Software (Materialise, Leuven, Belgium) are shown to visualize the stent’s placement in the LAD relative to the other major coronary arteries (MPEG 242,376 KB)

Movie 8.5. This animated movie depicts coronary sinus cannulation and lead placement in basal, midventricular, and apical locations during a biventricular pacing implant procedure (MPEG 3,959 KB)

Movie 8.6. 3D reconstruction of contrast-computed tomography images for the coronary arterial and venous systems (MP4 1,141 KB)

145597_3_En_8_MOESM4_ESM.avi

Movie 8.4. Stent implantation procedure. A guide wire is delivered through the left coronary ostium to the LAD. A CordisBx Velocity Rx® balloon expandable stent (4.0 mm inner diameter, 23 mm length) is then advanced over the guide wire. The stent is deployed by inflating the balloon to the manufacturer’s recommended pressure. The catheter is removed and the fiberscope, which is positioned distal to the stent, is advanced retrograde through the stent. Three-dimensional anatomical reconstructions using contrast-computed tomography scans and MIMICs Software (Materialise, Leuven, Belgium) are shown to visualize the stent’s placement in the LAD relative to the other major coronary arteries (MPEG 242,376 KB)

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Spencer, J.H., Anderson, S.E., Lahm, R., Iaizzo, P.A. (2015). The Coronary Vascular System and Associated Medical Devices. In: Iaizzo, P. (eds) Handbook of Cardiac Anatomy, Physiology, and Devices. Springer, Cham. https://doi.org/10.1007/978-3-319-19464-6_8

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