Visualisation of coronary venous anatomy by computed tomography angiography prior to cardiac resynchronisation therapy implantation

U. C. Nguyen*, M. J. M. Cluitmans, J. G. L. M. Luermans, M. Strik, C. B. de Vos, B. L. J. H. Kietselaer, J. E. Wildberger, F. W. Prinzen, C. Mihl, K. Vernooy

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background The purpose of this study was to illustrate the additive value of computed tomography angiography (CTA) for visualisation of the coronary venous anatomy prior to cardiac resynchronisation therapy (CRT) implantation. Methods Eighteen patients planned for CRT implantation were prospectively included. A specific CTA protocol designed for visualisation of the coronary veins was carried out on a third-generation dual-source CT platform. Coronary veins were semi-automatically segmented to construct a 3D model. CTA-derived coronary venous anatomy was compared with infra-procedural fluoroscopic angiography (FA) in right and left anterior oblique views. Results Coronary venous CTA was successfully performed in all 18 patients. CRT implantation and FA were performed in 15 patients. A total of 62 veins were visualised; the number of veins per patient was 3.8 (range: 2-5). Eighty-five per cent (53/62) of the veins were visualised on both CTA and FA, while 10% (6/62) were visualised on CTA only, and 5% (3/62) on FA only. Twenty-two veins were present on the lateral or inferolateral wall; of these, 95% (21/22) were visualised by CTA. A left-sided implantation was performed in 13 patients, while a right-sided implantation was performed in the remaining 2 patients because of a persistent left-sided superior vena cava with no left innominate vein on CTA. Conclusion Imaging of the coronary veins by CTA using a designated protocol is technically feasible and facilitates the CRT implantation approach, potentially improving the outcome.
Original languageEnglish
Pages (from-to)433-440
Number of pages8
JournalNetherlands Heart Journal
Volume26
Issue number9
DOIs
Publication statusPublished - 1 Sep 2018

Keywords

  • Coronary veins
  • Computed tomography angiography
  • Fluoroscopic angiography
  • Cardiac resynchronisation therapy
  • VENTRICULAR LEAD PLACEMENT
  • RESYNCHRONIZATION THERAPY
  • CT-ANGIOGRAPHY
  • SYSTEM
  • INFARCTION
  • SINUS

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