Prevalence and Sex-Related Structural Differences of the Thebesian Valve in a Select Kenyan Population: Autopsy Study
Abstract
Anatomical prevalence and sex-related structural variation of the Thebesian valve in a selected Kenyan autopsy population.
The coronary sinus is increasingly used during cardiovascular interventional procedures. The Thebesian valve is an endocardial remnant located at the coronary sinus opening into the right atrium and may hinder catheterization of the coronary sinus. Its morphology varies between individuals, but information concerning prevalence and morphology, particularly by sex and within African populations, remains limited. This study therefore investigated the prevalence and sex-related structural differences of the Thebesian valve.
A total of 100 post-mortem hearts were examined, comprising 63 male and 37 female specimens. The coronary sinus and Thebesian valve were measured, photographed and classified according to morphology. Statistical analyses included the Mann–Whitney U test and Spearman’s correlation.
The Thebesian valve was present in 73% of examined hearts and demonstrated varied morphologies. Absence of the valve was associated with a larger coronary sinus opening. Percentage occlusion of the coronary sinus opening was higher in males, although sex-related structural differences were not statistically significant. Age did not significantly influence valve morphology. Positive correlations were observed between heart size and coronary sinus dimensions.
The study demonstrates important anatomical variation in the Thebesian valve and coronary sinus within the selected Kenyan population. These variations may have clinical implications for cardiovascular interventional procedures requiring access to or catheterization of the coronary sinus.
Post-mortem human heart specimens included in the study.
Male hearts included in the anatomical assessment.
Female hearts included in the anatomical assessment.
Thebesian valve identified in the examined heart specimens.
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Descriptive Cross-Sectional Autopsy Study
The study examined post-mortem human heart specimens to describe the prevalence, morphology and structural variation of the coronary sinus opening and Thebesian valve in a selected Kenyan population.
100 Post-Mortem Hearts
One hundred specimens were examined: 63 male and 37 female hearts. Hearts without cardiac pathology were eligible for inclusion according to the study criteria.
Nairobi, Kenya
Specimens were obtained from Kenyatta National Hospital Funeral Home, Nairobi City Mortuary and Chiromo Funeral Parlor. Examination and analysis were undertaken through the Department of Human Anatomy, University of Nairobi.
Systematic Random Sampling
Available post-mortem specimens were stratified into age groups, followed by systematic random sampling within the relevant groups and subsequent classification by sex.
Morphology & Morphometry
The coronary sinus ostium and Thebesian valve were inspected, photographed and measured. Valve morphology, height, coronary sinus dimensions and percentage occlusion were assessed using anatomical measurements and electronic Vernier callipers.
SPSS Version 27
Data were analysed using SPSS version 27. Statistical testing included the Mann–Whitney U test and Spearman’s correlation, with morphometric variables standardised against heart weight where applicable.
KNH-UoN Ethics Approval
Ethical approval was granted by the
Kenyatta National Hospital–University of Nairobi
Ethics and Research Committee.
Approval reference:
UP53/02/2024.
Cadaveric Material Governance
Permission was obtained from the relevant mortuary authorities and families of the deceased were contacted for informed consent before autopsy material was used. The study also reports compliance with applicable Kenyan legislation governing anatomical and human tissue material.
Contributor Statement
Equal contributions.
Conflict of Interest & Funding
Conflict of Interest:
No conflict of interest.
Funding:
No funding received by the authors.
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Licence & Article Record
This article is published by
The Operating Room Global Journal (TORGJ)
under the Creative Commons Attribution
4.0 International licence (CC BY 4.0).
Persistent DOI:
10.64573/torgj2509007
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