Abstract
Background:The coronary venous system is increasingly targeted for pacing in patients with severe heart failure. The recent advancement of Multi-Detector Computed Tomography (MDCT) allows accurate analysis of the coronary arteries, but little data exist on its role in assessing cardiac venous anatomy. The aim of the present study was to investigate the feasibility of using MDCT in evaluating the cardiac venous anatomy in patients with heart disease; Methods and Results: One hundred and eighteen subjects (59 ± 11 years, 100 males) were studied by contrast enhanced 16-slice CT with retrospective ECG-reconstructions. The diameter, length, and angulations of coronary veins were measured from both volume rendered 3-dimensional images and curved multi-planar images. The coronary sinus vein was visualized in all of patients. However, the posterior, postero-lateral, lateral, antero-lateral and anterior veins were found in 71.2%, 50.0%, 65.3%, 9.3% and 96% patients, respectively. Twenty-three (19.5%) subjects had neither postero-lateral nor lateral cardiac veins. The ostial diameter angle of take-off and total length of the postero-lateral and lateral veins ranged from 1.7 - 7.0 mm, 38 - 160 degrees and 2.6 - 10.6 mm, respectively; Conclusions: This study confirms the feasibility of assessing diameter, length, and angulations of coronary veins by MDCT. This non-invasive information should be useful for pre-operative lead placement planning for patients scheduled to have cardiac resynchronization therapy.
Highlights
Multi-Detector Computer Tomography (MDCT) is a new tool for non-invasive cardiac imaging [1]
The recent advancement of Multi-Detector Computed Tomography (MDCT) allows accurate analysis of the coronary arteries, but little data exist on its role in assessing cardiac venous anatomy
The aim of the present study was to investigate the feasibility of using MDCT in evaluating the cardiac venous anatomy in patients with heart disease; Methods and Results: One hundred and eighteen subjects (59 ± 11 years, 100 males) were studied by contrast enhanced 16-slice CT with retrospective ECG-reconstructions
Summary
Multi-Detector Computer Tomography (MDCT) is a new tool for non-invasive cardiac imaging [1]. Recent advancement can be attributed to decreased detector size, increased number of detector rows (slices), improved reconstruction algorithms and faster rotations. These improvements have lead to acquisitions with shorter scan times with higher spatial and temporal resolutions [3,4,5,6]. Prior to placement of the pacemaker lead, patients would undergo an invasive cardiac venogram to see if they have suitable veins for CRT. The main purpose of the present study was to investigate the feasibility of assessing coronary venous system non-invasively in patients with heart disease using a retrospectively ECG-gated acquisition on a 16-slice CT scanner. Attention was focused on the availability and characteristics of coronary veins that were suitable for CRT
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