Fluoroscopy, echocardiography, blind digital approach, and direct visu
al insertion have been used for retrograde cannulation of the coronary
sinus. We cannulate the coronary sinus by transillumination using a s
tandard flexible retroplegia cannula with a reusable fiberoptic stylet
designed by our open heart program. An attachable light source illumi
nates the tip, which is guided into the coronary sinus ostium. We have
used the technique in 16 patients who could not be cannulated with th
e blind digital method.