Depiction of a new pulmonary vein variant using multidetector-row computed tomography

Abstract

A 52-year-old man without history of cardiac disease was referred to our hospital because of frequent episodes of paroxysmal atrial fibrillation that started 3 years earlier. He was admitted to our university hospital for catheter ablation of his atrial fibrillation. On physical examination, his blood pressure was 106/64 mm Hg and his pulse was 66 beats/min and irregular. The cardiothoracic ratio on a chest X-ray was 50%. The prothrombin time ratio was maintained in the range 1.2–1.5, corresponding to an international normalized ratio of 1.4–2.3 with warfarin [1]. Contrast-enhanced multidetector-row computed tomography (MDCT) was performed prior to the pulmonary vein isolation procedure by using an Aquillion 8 (8 detector rows; Toshiba Medical, Tokyo, Japan) with collimation of 0.5 mm, gantry rotation of 0.4 s and helical pitch of 3.2. The scan protocol and retrospectively ECG-gated image reconstruction method have been described previously [2]. The reconstructed data were transferred to a computer workstation (M 900 single, AMIN, Tokyo, Japan) for processing of the surface volume rendering and multiplanar reformatted images. The volume rendering image showed that there was a long left pulmonary vein trunk that bifurcated into the left superior and left inferior pulmonary veins (Figs. 1 and 2). The diameter of the left pulmonary vein trunk was 30 mm at its