OBJECTIVES: This study was designed to evaluate the value of 64-slice computed tomography (CT) to visualize the cardiac veins and evaluate the relation between variations in venous anatomy and history of infarction. BACKGROUND: Cardiac resynchronization therapy (CRT) is an attractive treatment for selected heart failure patients. Knowledge of venous anatomy may help in identifying candidates for successful left ventricular lead implantation. METHODS: The 64-slice CT of 100 individuals (age 61 +/- 11 years, 68% men) was studied. Subjects were divided into 3 groups: 28 control patients, 38 patients with significant coronary artery disease (CAD), and 34 patients with a history of infarction. Presence of the following coronary sinus (CS) tributaries was evaluated: posterior interventricular vein (PIV), posterior vein of the left ventricle, and left marginal vein (LMV). Vessel diameters were also measured. RESULTS: Coronary sinus and PIV were identified in all individuals. Posterior vein of the left ventricle was observed in 96% of control patients, 84% of CAD patients, and 82% of infarction patients. In patients with a history of infarction, a LMV was significantly less observed as compared with control patients and CAD patients (27% vs. 71% and 61%, respectively, p < 0.001). None of the patients with lateral infarction and only 22% of patients with anterior infarction had a LMV. Regarding quantitative data, no significant differences were observed between the groups. CONCLUSIONS: Non-invasive evaluation of cardiac veins with 64-slice CT is feasible. There is considerable variation in venous anatomy. Patients with a history of infarction were less likely to have a LMV, which may hamper optimal left ventricular lead positioning in CRT implantation.
OBJECTIVES: This study was designed to evaluate the value of 64-slice computed tomography (CT) to visualize the cardiac veins and evaluate the relation between variations in venous anatomy and history of infarction. BACKGROUND: Cardiac resynchronization therapy (CRT) is an attractive treatment for selected heart failurepatients. Knowledge of venous anatomy may help in identifying candidates for successful left ventricular lead implantation. METHODS: The 64-slice CT of 100 individuals (age 61 +/- 11 years, 68% men) was studied. Subjects were divided into 3 groups: 28 control patients, 38 patients with significant coronary artery disease (CAD), and 34 patients with a history of infarction. Presence of the following coronary sinus (CS) tributaries was evaluated: posterior interventricular vein (PIV), posterior vein of the left ventricle, and left marginal vein (LMV). Vessel diameters were also measured. RESULTS: Coronary sinus and PIV were identified in all individuals. Posterior vein of the left ventricle was observed in 96% of control patients, 84% of CAD patients, and 82% of infarctionpatients. In patients with a history of infarction, a LMV was significantly less observed as compared with control patients and CAD patients (27% vs. 71% and 61%, respectively, p < 0.001). None of the patients with lateral infarction and only 22% of patients with anterior infarction had a LMV. Regarding quantitative data, no significant differences were observed between the groups. CONCLUSIONS: Non-invasive evaluation of cardiac veins with 64-slice CT is feasible. There is considerable variation in venous anatomy. Patients with a history of infarction were less likely to have a LMV, which may hamper optimal left ventricular lead positioning in CRT implantation.
Authors: Antonio Sorgente; Quynh A Truong; Cristina Conca; Jagmeet P Singh; Udo Hoffmann; Francesco F Faletra; Catherine Klersy; Rinky Bhatia; Giovanni B Pedrazzini; Elena Pasotti; Tiziano Moccetti; Angelo Auricchio Journal: Am J Cardiol Date: 2008-07-10 Impact factor: 2.778
Authors: D Lumia; D Laganà; A Canì; M Mangini; A Giorgianni; T Cafaro; E Bertolotti; S Rizzo; E Cotta; F Caravati; I Caico; C Vite; G Carrafiello; C Fugazzola Journal: Radiol Med Date: 2009-07-01 Impact factor: 3.469
Authors: Wael AlJaroudi; Ji Chen; Wael A Jaber; Steven G Lloyd; Manuel D Cerqueira; Thomas Marwick Journal: Circ Cardiovasc Imaging Date: 2011-05 Impact factor: 7.792