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Cardiovascular diseases occupy a central place in the structure of morbidity and mortality in various population groups and in most cases occur with a heart rhythm disorder. One of the most common types of arrhythmia is atrial fibrillation, the morphological substrate for the development of which is the left atrium and the region of the pulmonary veins. In connection with the introduction of modern imaging systems into the practice of cardiac surgery, which enable a detailed study of the anatomy of the heart and its separate chambers, there is a need to study the features of the variant anatomy of the pulmonary veins of the human left atrium in the aspect of modern interventional cardiac surgery, which will make it possible to secure and accelerate surgical interventions performed in this area. The purpose of the study was the revealing of variant anatomy of the pulmonary veins using multislice computed tomography, depending on body type and gender. Heart tomograms of 70 patients were analyzed (8 of the 1st period of adulthood, 23 of the 2nd period of adulthood, 37 of the elderly, 2 of the senile age). Among them were 47 men - 67.1% and 23 women - 32.9%. As a result of the analysis of the obtained data, four variants of the confluence of the pulmonary veins into the left atrium were identified. Among all observations, a typical variant of the confluence of the pulmonary veins into the left atrium occurs in 78.6% of cases, in 85.7% of cases - in persons of the pyknic type, in 85.0% of cases - in the examined asthenic type and in 69.0% of cases - in representatives of the normosthenic body type. Less common are the common pulmonary vein collector on the left (12.9%), as well as the accessory pulmonary vein on the right (7.1%). An extremely rare anatomical variant was the common pulmonary vein collector on both sides (1.4%). Thus, the anatomy of the distal pulmonary veins is characterized by significant variability, there is a slight relationship with gender and body type. An in-depth study of the anatomy of the pulmonary veins remains relevant for the effective implementation of surgical interventions in this anatomical zone.
Cardiovascular diseases occupy a central place in the structure of morbidity and mortality in various population groups and in most cases occur with a heart rhythm disorder. One of the most common types of arrhythmia is atrial fibrillation, the morphological substrate for the development of which is the left atrium and the region of the pulmonary veins. In connection with the introduction of modern imaging systems into the practice of cardiac surgery, which enable a detailed study of the anatomy of the heart and its separate chambers, there is a need to study the features of the variant anatomy of the pulmonary veins of the human left atrium in the aspect of modern interventional cardiac surgery, which will make it possible to secure and accelerate surgical interventions performed in this area. The purpose of the study was the revealing of variant anatomy of the pulmonary veins using multislice computed tomography, depending on body type and gender. Heart tomograms of 70 patients were analyzed (8 of the 1st period of adulthood, 23 of the 2nd period of adulthood, 37 of the elderly, 2 of the senile age). Among them were 47 men - 67.1% and 23 women - 32.9%. As a result of the analysis of the obtained data, four variants of the confluence of the pulmonary veins into the left atrium were identified. Among all observations, a typical variant of the confluence of the pulmonary veins into the left atrium occurs in 78.6% of cases, in 85.7% of cases - in persons of the pyknic type, in 85.0% of cases - in the examined asthenic type and in 69.0% of cases - in representatives of the normosthenic body type. Less common are the common pulmonary vein collector on the left (12.9%), as well as the accessory pulmonary vein on the right (7.1%). An extremely rare anatomical variant was the common pulmonary vein collector on both sides (1.4%). Thus, the anatomy of the distal pulmonary veins is characterized by significant variability, there is a slight relationship with gender and body type. An in-depth study of the anatomy of the pulmonary veins remains relevant for the effective implementation of surgical interventions in this anatomical zone.
We present a case of successful intracardiac echocardiography guided left atrial appendage catheter closure in a patient with esophageal varices using deflectable delivery sheath to improve ICE-catheter stability.
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