Thebesian valve

Last revised by Joachim Feger on 10 Dec 2021

The Thebesian valve, also known as the valve of the coronary sinus, is a fold in the right atrium at the opening of the coronary sinus 1.

The valve can create difficulties and interfere with the cannulation of the coronary sinus during cardiac resynchronisation therapy (CRT) 1.

The Thebesian valve is a semicircular remnant of the embryologic sinoatrial valve, in most cases membranous in composition and is located at the medial aspect of the posteroinferior wall of the right atrium right at the opening of the coronary sinus 1,2.

The Thebesian valve was found to present in about 70% in autopsies 1 and could be visualized in imaging studies in a range of 40-70% of cases 2,3 and covers the coronary sinus ostium in variable types and extents of which the whole coverage of coronary sinus ostium by the semilunar membrane is the most common. Other types of Thebesian valves show incomplete coverage arising either from the anteroposterior wall or the interatrial septum or both with a gap in between 1-3.

The Thebesian valve can be visualized on contrast-enhanced cardiac CT, cardiac MRI and also on transesophageal echocardiography 1-4.

The Thebesian valve is named after the Silesian physician Adam Christian Thebesius (1686-1732) 6, who described the valve in his anatomy dissertation ‘Disputatio medica inauguralis de circulo sanguinis in corde’ when he graduated from Leiden University in 1708 5.

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