Clinical anatomy of vein of Marshall chemical ablation for persistent atrial fibrillation
Objective:To explore the anatomical basis of vein of Marshall(VOM)chemical ablation for the treatment of persistent atrial fibrillation.Methods:Thirty-four 10%formalin-fixed adult heart specimens were selected and the VOM was dissected and statistically analyzed.Using a vernier caliper,the VOM length,the outer diameter of its end,the distance from the VOM opening to the orifice of coronary sinus,and the outer diameter of the coronary sinus and the outer diameter of the coronary sinus at the point where the VOM converges were measured.The length of the coronary sinus and its longitudinal and transverse diameters,as well as the angle between the VOM and the coronary sinus,were measured.Results:The VOM length was(32.53±11.72)mm.The outer diameter of the end of VOM was(1.82±0.50)mm,and the proportion of cases that could be accessed using a 5F JR4 guiding catheter was 60.71%.The distance from the VOM opening to the orifice of the coronary sinus was(36.21±11.57)mm.The outer diameter at the point where the VOM converges with the coronary sinus was(7.42±2.09)mm.The angle between the VOM and the coronary sinus was(43.98±15.75)°.The length of the coronary sinus was(61.84±15.37)mm,with a longitudinal diameter of the sinus orifice being(12.61±3.15)mm,and a transverse diameter of(8.07±2.25)mm.The differences between the longitudinal diameter and the transverse diameter of the coronary sinus orifice,as well as the outer diameter at the point where the VOM converges with the coronary sinus,were statistically significant.The differences between the lengths of the coronary sinus and the distance from the VOM opening to the coronary sinus orifice were also statistically significant.The other items showed no statistically significant differences in comparison between genders.Conclusion:This study measured the length and outer diameter of VOM at a gross anatomical level,providing morphological references for the application of VOM chemical ablation therapy in treating persistent atrial fibrillation.
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