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Usefulness of multidetector computed tomography coronary venous angiography examination before cardiac resynchronization therapy

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Abstract

Purpose

Cardiac resynchronization therapy (CRT) is a treatment option for selected heart failure patients. In this study, the aim was to evaluate the usefulness of noninvasive cardiac vein imaging using multidetector computed tomography (MDCT) angiography before CRT.

Materials and methods

The MDCT scans of 34 patients (20 men; age range 47–65 years) with a history of cardiac failure were studied for CRT in two centers prospectively. The anatomy of the cardiac venous system, particularly the target veins [left marginal vein (LMV) and posterior vein of the left ventricle (PVLV)], was evaluated with noninvasive MDCT.

Result

The coronary sinus, anterior interventricular vein, and posterior interventricular vein were observed in all patients. The PVLV was present in 30 (88.2%) patients. The PVLV was chosen in 30 (88.2%) patients for CRT. If the PVLV had two or more branches, the widest branch was chosen for lead implantation. In four (11.7%) patients, the PVLV was absent and the LMV was chosen instead for lead implantation. In one patient (2.9%), partial thrombosis was detected in the coronary sinus with MDCT angiography.

Conclusion

MDCT can be used to guide interventionalists for CRT by providing anatomical details of the cardiac venous system rapidly and noninvasively.

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References

  1. Tada H, Kurosaki K, Naito S, Koyama K, Itoi K, Ito S, et al. Three-dimensional visualization of the coronary venous system using multidetector row computed tomography. Circ J 2005;69:165–170.

    Article  PubMed  Google Scholar 

  2. Mühlenbruch G, Koos R, Wildberger JE, Günther RW, Mahnken AH. Imaging of the cardiac venous system: comparison of MDCT and conventional angiography. AJR Am J Roentgenol 2005;185:1252–1257.

    Article  PubMed  Google Scholar 

  3. Jongbloed MR, Lamb HJ, Bax JJ, Schuijf JD, de Roos A, van der Wall EE, et al. Noninvasive visualization of the cardiac venous system using multislice computed tomography. J Am Coll Cardiol 2005;45:749–753.

    Article  PubMed  Google Scholar 

  4. Mlynarski R, Sosnowski M, Wlodyka A, Kargul W, Tendera M. A user-friendly method of cardiac venous system visualization in 64-slice computed tomography. Pacing Clin Electrophysiol 2009;32:323–329.

    Article  PubMed  Google Scholar 

  5. Saremi F, Krishnan S. Cardiac conduction system: anatomic landmarks relevant to interventional electrophysiologic techniques demonstrated with 64-dedector CT. Radiographics 2007;27:1539–1567.

    Article  PubMed  Google Scholar 

  6. Chiribiri A, Kelle S, Götze S, Kriatselis C, Thouet T, Tangcharoen T, et al. Visualization of the cardiac venous system using cardiac magnetic resonance. Am J Cardiol 2008;101:407–412.

    Article  PubMed  Google Scholar 

  7. Chiribiri A, Kelle S, Köhler U, Tops LF, Schnackenburg B, Bonamini R, et al. Magnetic resonance cardiac vein imaging: relation to mitral valve annulus and left circumflex coronary artery. JACC Cardiovasc Imaging 2008;1:729–738.

    Article  PubMed  Google Scholar 

  8. Leschka S, Stolzmann P, Desbiolles L, Baumueller S, Goetti R, Schertler T, et al. Diagnostic accuracy of high-pitch dualsource CT for the assessment of coronary stenoses: first experience. Eur Radiol 2009;19:2896–2903.

    Article  PubMed  Google Scholar 

  9. Van de Veire NR, Schuijf JD, De Sutter J, Devos D, Bleeker GB, de Roos A, et al. Non-invasive visualization of the cardiac venous system in coronary artery disease patients using 64-slice computed tomography. J Am Coll Cardiol 2006;48:1932–1938.

    Google Scholar 

  10. Strickberger SA, Conti J, Daoud EG, Havranek E, Mehra MR, Piña IL, et al. Patient selection for cardiac resynchronization therapy: from the Council on Clinical Cardiology Subcommittee on Electrocardiography and Arrhythmias and the Quality of Care and Outcomes Research Interdisciplinary Working Group, in collaboration with the Heart Rhythm Society. Circulation 2005;111:2146–2150.

    Article  PubMed  Google Scholar 

  11. Nelson GS, Curry CW, Wyman BT, Kramer A, Declerck J, Talbot M, et al. Predictors of systolic augmentation from left ventricular preexcitation in patients with dilated cardiomyopathy and intraventricular conduction delay. Circulation 2000;101:2703–2709.

    PubMed  CAS  Google Scholar 

  12. Nelson GS, Berger RD, Fetics BJ, Talbot M, Spinelli JC, Hare JM, et al. Left ventricular or biventricular pacing improves cardiac function at diminished energy cost in patients with dilated cardiomyopathy and left bundle-branch block. Circulation 2000;102:3053–3059.

    PubMed  CAS  Google Scholar 

  13. Sa MI, de Roos A, Westenberg JJ, Kroft LJ. Imaging techniques in cardiac resynchronization therapy. Int J Cardiovasc Imaging 2006;24:89–105.

    Article  Google Scholar 

  14. Puglisi A, Lunati M, Marullo AG, Bianchi S, Feccia M, Sgreccia F, et al. Limited thoracotomy as a second choice alternative to transvenous implant for cardiac resynchronization therapy delivery. Eur Heart J 2004;25:1063–1069.

    Article  PubMed  Google Scholar 

  15. Meisel E, Pfeiffer D, Engelmann L, Tebbenjohanns J, Schubert B, Hahn S, et al. Investigation of coronary venous anatomy by retrograde venography in patients with malignant ventricular tachycardia. Circulation 2001;104:442–447.

    Article  PubMed  CAS  Google Scholar 

  16. De Martino G, Messano L, Santamaria M, Parisi Q, Dello Russo A, Pelargonio G, et al. A randomized evaluation of different approaches to coronary sinus venography during biventricular pacemaker implants. Europace 2005;7:73–76.

    Article  PubMed  Google Scholar 

  17. Abbara S, Cury RC, Nieman K, Reddy V, Moselewski F, Schmidt S, et al. Noninvasive evaluation of cardiac veins with 16-MDCT angiography. AJR Am J Roentgenol 2005;185:1001–1006.

    Article  PubMed  Google Scholar 

  18. Meisel E, Butter C, Philippon F, Higgins S, Strickberger SA, Smith J, et al. Transvenous biventricular defibrillation. Am J Cardiol 2000;86:76–85.

    Article  Google Scholar 

  19. Koos R, Sinha AM, Markus K, Breithardt OA, Mischke K, Zarse M, et al. Comparison of left ventricular lead placement via the coronary venous approach versus lateral thoracotomy in patients receiving cardiac resynchronization therapy. Am J Cardiol 2004;94:59–63.

    Article  PubMed  Google Scholar 

  20. Abraham WT, Hayes DL. Cardiac resynchronization therapy for heart failure. Circulation 2003;108:2596–2603.

    Article  PubMed  Google Scholar 

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Correspondence to Mecit Kantarci.

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Doganay, S., Karaman, A., Gündogdu, F. et al. Usefulness of multidetector computed tomography coronary venous angiography examination before cardiac resynchronization therapy. Jpn J Radiol 29, 342–347 (2011). https://doi.org/10.1007/s11604-011-0565-y

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  • DOI: https://doi.org/10.1007/s11604-011-0565-y

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