Noninvasive visualization of the cardiac venous system using multislice computed tomography
Noninvasive visualization of the cardiac venous system using multislice computed tomography
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DOI：
10.1016/j.jacc.2004.11.035
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发表时间：
2005-03-01
影响因子：
24
通讯作者：
Schalij, MJ
中科院分区：
文献类型：
--
作者：
Jongbloed, MRM;Lamb, HJ;Schalij, MJ
背景在心脏起搏治疗（CRT）过程中，左心室（LV）起搏是通过冠状窦（CS）分支中的起搏器导线建立的。CS的解剖结构和变化的知识可能有助于LV leads.METHODS的植入38例患者（34名男性，年龄60 +/- 12岁）的MSCT扫描进行了研究。解剖变异分为三组，取决于心脏静脉系统的连续性在心结。测量了冠状窦口和主要分支之间的距离。结果最常见的变异是冠状窦和小心静脉分别插入右心房（24例[63%]）。11例（29%）患者在心结处前后静脉系统连续。在3例患者（8%）中，后室间静脉（PIV）未连接至CS。PIV至左心室后静脉（PVLV）的平均距离为42.4 ± 18.1 mm，PVLV至左边缘静脉（LMV）的平均距离为39.9 ± 15.6 mm，从LMV到前室间静脉的距离为45.4 ± 15.3 mm，CS口的直径为12.6 ± 15.3 mm，结论：MSCT可用于评价CS及其属支的解剖结构。由于观察到解剖结构的实质性变化，植入前了解静脉解剖结构可能有助于决定CRT的经静脉LV电极导线置入是否可行。(C)2005年，美国心脏病学会基金会。
OBJECTIVES We sought to evaluate the value of multislice computed tomography (MSCT) to depict the cardiac venous anatomy.BACKGROUND During cardiac resynchronisation therapy (CRT), left vcntricular (LV) pacing is established by a pacemaker lead in a tributary of the coronary sinus (CS). Knowledge of the CS anatomy and variations may facilitate the implantation of LV leads.METHODS The MSCT scans of 38 patients (34 men; age 60 +/- 12 years) were studied. Anatomical variants were divided in three groups, dependent on the continuity of the cardiac venous system at the crux cordis. The CS ostium and distances between the main tributaries were measured.RESULTS The most frequently observed variant had a separate insertion of the CS and the small cardiac vein in the right atrium (24 patients [63%]). In 11 patients (29%), there was continuity of the anterior and posterior venous system at the crux cordis. In three patients (8%), the posterior interventricular vein (PIV) did not connect to the CS. The mean distance from the PIV to the posterior vein of the left ventricle (PVLV) was 42.4 +/- 18.1 mm, from the PVLV to the left marginal vein (LMV) 39.9 +/- 15.6 mm, and from the LMV to the anterior interventricular vein 45.4 +/- 15.3 mm. The diameter of the CS ostium was 12.6 +/- 3.6 nun in anteroposterior and 15.5 +/- 4.5 turn in the superoinferior direction (p < 0.01).CONCLUSIONS The anatomy of the CS and its tributaries can be evaluated using MSCT. As substantial variation in anatomy was observed, pre-implantation knowledge of the venous anatomy may help to decide whether transvenous LV lead placement for CRT is feasible. (C) 2005 by the American College of Cardiology Foundation.