A User-Friendly Method of Cardiac Venous System Visualization in 64-Slice Computed Tomography

• Published in: Pacing and clinical electrophysiology Vol. 32; no. 3; pp. 323 - 329
• Main Authors: MLYNARSKI, RAFAL, SOSNOWSKI, MACIEJ, WLODYKA, AGNIESZKA, KARGUL, WLODZIMIERZ, TENDERA, MICHAL
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-03-2009
• Subjects: Algorithms; cardiac resynchronization therapy; computed tomography; Computer Graphics; Coronary Angiography - methods; coronary sinus; coronary veins; Female; heart failure; Humans; Imaging, Three-Dimensional - methods; Male; Middle Aged; Phlebography - methods; Radiographic Image Enhancement - methods; Radiographic Image Interpretation, Computer-Assisted - methods; Reproducibility of Results; Sensitivity and Specificity; target veins; Tomography, X-Ray Computed - methods; User-Computer Interface
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.2008.02239.x

Background: Previsualization of the cardiac venous system is very important for some techniques, for example, cardiac resynchronization therapy (CRT). The aim of this study was to propose a new, user‐friendly method of cardiac venous system visualization in 64‐slice computed tomography (CT).
Methods: In 112 patients (66 M) aged 58 ± 11 standard deviation, a 64‐slice CT with a retrospective electrocardiogram gating was performed due to a suspicion of ischemic heart disease. Special attention was paid to the requirements for image reconstruction useful for CRT.
Results: In 74% of the patients, it was possible to obtain similar images to those during the CRT implantation procedure within anterior‐posterior, left anterior oblique, and right anterior oblique views. The coronary sinus was clearly visible in all cases, the ostium measured 12.9 ± 5.9 mm, and the angle of entrance 99 ± 12 degrees. In all patients it was possible to demonstrate more than one vein; in 95%, at least one vein was clearly visible in the target area. Among the target veins, the posterolateral vein was visible most frequently (78%) in the cases as well as the lateral vein (78%).
Conclusion: The proposed scheme in 64‐slice computed tomography enables images to be generated similar to the intraoperative fluoroscopy, which can be useful in techniques where previsualization of the cardiac venous system is recommended.