Abstract
PurposePulmonary veins are involved in pathogenesis and treatment of atrial fibrillation and structures at risk during thoracic surgeries. There is lack of data regarding pulmonary vein morphology and morphometry in normal population.MethodsThe study was conducted using 135 chest computed tomography studies with intra-venous iodine contrast injection. The study population contained 86 females and 49 males, mean age was 60. 13 had atrial fibrillation. The studies were analyzed using radiological workstation.ResultsMean dimensions of the left atrium: transverse 52 mm, coronal 49 mm, and sagittal 35 mm. The mean volume of the left atrium was 93 cm3. The mean volume of the left atrium in patients with atrial fibrillation was 176 cm3. The sagittal dimension and the volume of the left atrium were correlated with age, r = 0.43 and r = 0.42, respectively. Surface area of the left inferior pulmonary vein ostium was 136 mm2, significantly less than the surface area of other ostia of pulmonary veins. The mean distance between two pulmonary veins was 5.42 mm on the right and 4.02 mm on the left side. 13 types of pulmonary veins outflow patterns were described on the right side and 5 types on the left side. 66.7% of right pulmonary veins and 82% of the left pulmonary veins emptied into the left atrium with two venous trunks on each side (the typical pattern).ConclusionsMorphological features of pulmonary veins and morphometry of the left atrium and pulmonary veins are important for clinical purposes and are in accordance with previous papers.
Highlights
Pulmonary veins (PVs) and the left atrium (LA) are central in pathogenesis of atrial fibrillation (AF) [9, 26]
In subgroup without AF (AF−) LAsag 90p was 41.00 mm, so it was significantly different when compared to AF positive (AF+) subgroup, where LAsag 10p = 39.20 mm, so an arbitrary value of 40 mm for LAsag was a distinction to predict whether it was AF positive or negative case
LA volume was significantly different when AF was taken into consideration, the median volume was twice higher in AF+ subgroup, compared to AF− subgroup, 166.56 cm3 and 78.95 cm3 for cuboid shape, respectively
Summary
Pulmonary veins (PVs) and the left atrium (LA) are central in pathogenesis of atrial fibrillation (AF) [9, 26] This supraventricular tachyarrhythmia propagates from the proximal part of PVs (ectopic beats starts mainly in upper PVs) [12], but is the main cause of morphometric changes of LA and the proximal part of PVs [15]. With VATS the vison is limited, it can lead to misinterpreting the vascular structures [35] and cause potential surgical complications [25]. This is why it is so important to establish vascular anatomy prior to surgical treatment [11]. The use of multi-slice computed tomography (MSCT) with volume-rendering technique (VRT) before surgery leads to a better understanding of the vascular anatomy and facilitates guidance during resection [1]
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