title: Comparative prospective randomized efficacy testing of different guiding catheters for coronary sinus cannulation in heart failure patients.
abstract: BACKGROUND
  The efficacy of different shapes of guiding catheters for coronary sinus (CS) cannulation was evaluated at implant of a cardiac resynchronization therapy device that required transvenous placement of a pacing lead in a coronary vein on the left ventricle.
  
  
  RESULTS
  Comparative testing of 5 different guiding catheter shapes was attempted in 29 consecutive patients. Four newer guiding catheters were tested in a prospective randomized manner with a reference standard catheter always tested in the last place. All of the new catheters included a distal shape that consisted of a single curve or a compound set of curves at the catheter tip, followed by a catheter shaft design which fell into one of two classes: (1). straight shaft catheters and (2). curved shaft catheters. The curved shaft class of catheters, two new and one standard, achieved higher (16/23 (70%), 17/23 (74%) and 17/22 (77%)) CS cannulation success rates than the straight shaft class catheters ((13/23 (56%) and 12/23 (52%)). The pairing of two catheters, one from each class in a single patient, or both from the curved shaft class resulted in a combined CS cannulation success rate of up to 96%. Two of the catheters were more effective from a left hand insertion than from a right hand insertion site.
  
  
  CONCLUSIONS
  The ability to switch between guiding catheters with different shapes and compound curves can improve the CS cannulation success rate. The selection of guiding catheters should be influenced by the intended use of the catheter either from the left or from the right hand side.
authors: German Heart Institute, Berlin, Germany. butter@dhzb.de
authors: Christian
authors: C
authors: Butter
authors: Daniel
authors: D
authors: Gras
authors: Philippe
authors: P
authors: Ritter
authors: Christoph
authors: C
authors: Stellbrink
authors: Eckart
authors: E
authors: Fleck
authors: Bruce
authors: B
authors: Tockman
authors: Bernd
authors: B
authors: Schubert
authors: Thierry
authors: T
authors: Pochet
authors: Willem
authors: W
authors: deVoogt
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation*; D002304:Cardiac Pacing, Artificial; D002404:Catheterization; D004567:Electrodes, Implanted; D004867:Equipment Design; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D011446:Prospective Studies