Evaluation of pulmonary vein variations and anomalies with 64 slice multi detector computed tomography

Tekbaş, Güven; Gümüş, Hatice; Önder, Hakan; Ekıcı, Faysal; Hamidi, Cihad; Tekbaş, Ebru; Gulicetincakmak, Mehmet; Yavuz, Celal; Bilici, Aslan

doi:10.1007/s00508-011-0086-9

Cited by 24 publications

(24 citation statements)

References 20 publications

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“…The next common drainage pattern on the right side was three pulmonary veins with three ostia (24%) and on the left side, they noticed a single pulmonary vein with a single ostium in14% of specimens. Earlier, it was found that, variations in the right pulmonary vein drainage were more common than those on the left [1,5]. Similarly, in the present study also, about 28% cases showed variable pulmonary veins on the right side and only 6% showed variations in the left pulmonary veins.…”

Section: Resultssupporting

confidence: 83%

“…Knowledge on such variations is significantly important for radiologists and thoracic surgeons prior to the performance of procedures which directly or indirectly involve the pulmonary veins. [1,3,5]. Marom EM et al, divided the pulmonary vein and its drainage orifices into 6 patterns on the right side and 2 patterns on the left side [3].…”

Section: Resultsmentioning

confidence: 99%

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confidence: 99%

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Variations in the Pulmonary Venous Ostium in the Left Atrium and Its Clinical Importance

Prasanna

Praveena

D’Souza

et al. 2014

JCDR

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IntrOductIOnIn the past decade, pulmonary veins have been known to play an important role as the triggering focus of the electrical activity in atrial fibrillation [1]. Earlier, it was considered that the variations in the number and course of pulmonary veins were rare and they were confined only to few case reports [2]. Recently, however, it has been found that variations in pulmonary venous anatomy were seen in 36% of patients [3] and that they were one of the aetiologies for ectopic heart beats [4]. This greater than expected variability in pulmonary venous anatomy could substantially alter success rates of radiofrequency ablation, as ectopic foci could go untreated in variant veins. Increasingly, selective radiofrequency ablations of these arrythmogenic foci are being performed, to treat patients with refractory atrial fibrillation [5]. The successful treatment of atrial fibrillation by radiofrequency ablation of the ectopic foci can be made possible only by having accurate knowledge on the normal pulmonary venous anatomy and its measurement. Thus, the present study was done to find out the variations in the number of right and left pulmonary veins which drained into the left atrium. MAterIAls And MethOdsThe present study was done on 50 formalin fixed hearts which were obtained from the Department of Anatomy. Left atria of these hearts were studied from external aspect, for the variations in the number of pulmonary veins which drained into it. Left atrium were opened by making a midline incision along the whole length of its posterior wall and the number of pulmonary ostia which opened into the left atrium were identified and documented. resultsThirty-four heart specimens (68%) had normal four pulmonary veins, two from each lung which extended to the left atrium and opened into it via two separate pulmonary ostia, on either side. In 16 (32%) out of 50 specimens, variations in the number of pulmonary veins and the pulmonary ostia were observed either on one side or on both sides of the left atrium.Following variations were recorded in our study: Seven specimens (14%) had a single pulmonary vein with a single ostium on the right side and two pulmonary veins on left side of the left atrium. Six specimens (12%) had three pulmonary veins with three ostia on the right side and two veins on the left side. Two specimens (4%) showed a single pulmonary vein and an ostium on the left side of the left atrium. The remaining 2% of the hearts presented with four separate pulmonary veins with four ostia, along with single left side pulmonary veins opening into the left atrium.Overall, in our study, the most common variation which was observed in the number of pulmonary veins on right side was a single pulmonary vein (14%), followed by three veins in 12% specimens, a normal pattern of two veins in 4% specimens, and four pulmonary veins in 2% of specimens. In contrast to the right side, left side showed no such variants, except a single left pulmonary vein which drained into the left atrium in 50% of specimens and rest of th...

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Section: Resultssupporting

confidence: 83%

Section: Resultsmentioning

confidence: 99%

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Variations in the Pulmonary Venous Ostium in the Left Atrium and Its Clinical Importance

Prasanna

Praveena

D’Souza

et al. 2014

JCDR

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“…Due to the lack of large epidemiological survey and a unified definition, the exact incidence of an LCPV is unclear. In the general population, it was reported that the prevalence of an LCPV ranged from 1% to 19% . However, in patients with AF, an LCPV seemed to be more common with an incidence of 7.5%‐43% .…”

Section: Discussionmentioning

confidence: 99%

A left common pulmonary vein: Anatomical variant predicting good outcomes of repeat catheter ablation for atrial fibrillation

Xing

et al. 2019

Cardiovasc electrophysiol

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Introduction A left common pulmonary vein (LCPV) is a common anatomical variant in atrial fibrillation (AF) patients. Whether an LCPV influences outcomes of repeated radiofrequency catheter ablation (RFCA) for AF has not been elucidated. Methods From a prospectively collected database, we enrolled 154 patients who received repeated RFCA for recurrent AF after the initial RFCA (56 ± 9 years, 72% paroxysmal AF, 32 patients with an LCPV, and 122 patients with typical left‐sided pulmonary veins [PVs]). Median postprocedural follow‐up was 26 months. The primary outcome was an episode of AF, atrial tachyarrhythmia, or atrial flutter lasting for more than 30 seconds, after the 3 months blanking period following the repeated procedure. Results After the follow‐up period, 75 patients suffered recurrence after repeated ablation. In the Kaplan‐Meier analysis, an LCPV was significantly associated with less recurrence (hazard ratio [HR]: 0.39; 95% confidence interval [CI]: 0.28‐0.79; P = 0.005). In subgroup analysis, the significant association persisted in paroxysmal AF patients. Regarding persistent AF patients, an LCPV tended to be associated with less recurrence with no statistical significance (HR: 0.40; 95% CI: 0.20‐1.03; P = 0.067). In multivariate analyses, an LCPV still independently predicted freedom from recurrence (HR: 0.44; 95% CI: 0.22‐0.88; P = 0.02). Conclusion Compared with typical left‐sided PVs, an LCPV was independently associated with better outcomes after repeated RFCA of AF, particularly in patients with paroxysmal AF.

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“…The embryological formation of the pulmonary veins is quite complex and there is a remarkable diversity of pulmonary vein connections into the left atrium [71][72][73][74]. The classical description of two left-sided (left superior (LSPV) and left inferior (LIPV)) and two right-sided (right superior (RSPV) and right inferior (RIPV)) separately ending pulmonary veins accounts for only ,70% of the normal population.…”

Section: Anatomy Of the Mediastinal Pulmonary Veinsmentioning

confidence: 99%

Haemoptysis due to pulmonary venous stenosis

Braun¹,

Platzek²,

Zöphel³

et al. 2014

European Respiratory Review

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Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10-20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe.A review of the literature was performed using the Medline/PubMed database with the terms: ''pulmonary venous stenosis'', ''pulmonary venous infarction'' and ''haemoptysis''. Further references from the case reports were considered.58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis.Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrastenhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis. @ERSpublications Pulmonary venous stenosis should be considered in haemoptysis and is best diagnosed using CT or MRI venography http://ow.ly/tMPFP

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Evaluation of pulmonary vein variations and anomalies with 64 slice multi detector computed tomography

Cited by 24 publications

References 20 publications

Variations in the Pulmonary Venous Ostium in the Left Atrium and Its Clinical Importance

Variations in the Pulmonary Venous Ostium in the Left Atrium and Its Clinical Importance

A left common pulmonary vein: Anatomical variant predicting good outcomes of repeat catheter ablation for atrial fibrillation

Haemoptysis due to pulmonary venous stenosis

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