Dr. Pepper was the holder of a British Heart Foundation International Fellowship. Dr. Davidson was the holder of a fellowship from the Peel Medical Research Trust.
Use of a Long Preshaped Sheath to Facilitate Cannulation of the Coronary Sinus at Electrophysiologic Study
Version of Record online: 13 AUG 2003
© Futura Publishing Company, Inc. 2001
Journal of Cardiovascular Electrophysiology
Volume 12, Issue 12, pages 1335–1337, December 2001
How to Cite
PEPPER, C. B., DAVIDSON, N. C. and ROSS, D. L. (2001), Use of a Long Preshaped Sheath to Facilitate Cannulation of the Coronary Sinus at Electrophysiologic Study. Journal of Cardiovascular Electrophysiology, 12: 1335–1337. doi: 10.1046/j.1540-8167.2001.01335.x
- Issue online: 13 AUG 2003
- Version of Record online: 13 AUG 2003
- Manuscript received 22 August 2001; Accepted for publication 11 October 2001.
- Cited By
- coronary sinus;
- electrophysiologic study;
CS Cannulation Using a Long Sheath. Introduction: Catheterization of the coronary sinus (CS) from the femoral vein can be challenging. We tested whether use of a long preshaped sheath facilitates CS cannulation.
Methods and Results: One hundred four patients were randomized into two phases. In phase 1, consecutive patients were allocated to CS catheterization using the long sheath (n = 26) or standard 7-French 15-cm sheath (n = 25). If unsuccessful within 10 minutes, the alternative technique was used. Phase 2 assessed the utility of the long sheath in difficult cases. All patients initially were approached using the standard sheath. If cannulation failed after 10 minutes, patients were randomly allocated to the standard or long sheath approach. In phase 1, the standard approach failed in 4 (16%) of 25 cases. In each case, a long sheath proved successful (mean 3.2 min). The long sheath approach was successful within 10 minutes in all 26 cases. Catheter deployment was significantly quicker with the long sheath, but this was offset by the time required for sheath insertion. In phase 2, the standard approach was successful in 46 (87%) of 53 cases. Of 7 “failures,” 3 were randomized to continue the standard approach, which was successful in 1; 4 were randomized to the long sheath approach, and success was achieved in all (mean 4.4 ± 1.5 min). Overall, the CS could not be promptly catheterized in 15% of cases within 10 minutes using the standard sheath, and no failures were seen using the long sheath. No complications arose from the use of either technique.
Conclusion: The long sheath was uniformly successful in permitting catheterization of the CS from the femoral approach in both unselected and difficult cases.