The Coronary Vascular System and Associated Medical Devices
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 my
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Julianne H. Spencer, Sara E. Anderson, Ryan Lahm, and Paul A. Iaizzo
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. Keywords
Coronary arteries • Coronary veins • Venous valves • Stents • Transvenous pacing leads
Electronic supplementary material: The online version of this chapter (doi:10.1007/978-3-319-19464-6_8) contains supplementary material, which is available to authorized users. Videos can also be accessed at http://link.springer.com/book/10.1007/978-3-319-19464-6_8. J.H. Spencer, PhD (*) Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA Department of Surgery, University of Minnesota, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN 55455, USA Medtronic, Inc., 8200 Coral Sea Street NE, Mounds View, MN 55112, USA e-mail: [email protected]; [email protected] S.E. Anderson, PhD • P.A. Iaizzo, PhD Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA Department of Surgery, University of Minnesota, B172 Mayo, MMC 195, 420 Delaware Street SE, Minneapolis, MN 55455, USA R. Lahm, MS Medtronic, Inc., 8200 Coral Sea Street NE, Mounds View, MN 55112, USA
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Introduction
While anatomical studies of the heart began centuries ago, Herophilus (c. 335–c. 280 bc) was the first to observe and record differences between coronary arteries and veins, including the discovery that arteries were much thicker than veins; veins, in contrast to arteries, collapsed when emptied of blood [1]. More than a thousand years later, in 1628 ad, William Harvey, court physician to King James I and King Charles I, published “On the motion of the heart and blood in animals,” the first accurate description of the circulatory system [2]. Subsequently, in 1689, Scaramucci conjectured that the contraction of the heart displaced blood from deeper coronary vessels into coronary veins [3]. However, the exact details of coronary blood flows were not well understood until the technology capable of measuring arterial and venous flows was more recently developed [3]. Today, it is known that the coronary system is comprised of arteries, arterioles, capillaries, and cardiac venules and veins. The cor
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