Investigation of Coronary Venous Anatomy by Retrograde Venography in Patients With Malignant Ventricular Tachycardia

Meisel, Eckhard; Pfeiffer, Dietrich; Engelmann, L.; Tebbenjohanns, Jürgen; Schubert, Bernd; Hahn, Stephen J.; Fleck, Eckart; Butter, Christian

doi:10.1161/hc2901.093145

Cited by 127 publications

(80 citation statements)

References 11 publications

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“…There are several types of coronary venous system imaging, each of which has its own advantages and disadvantages (12,(20)(21)(22)(23). The conventional method used to evaluate coronary venous system is invasive retrograde cardiac venography.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to cardiac pacing, this route may also be used for percutaneous venous interventional procedures, such as transcoronary venous ablation, percutaneous mitral annuloplasty, and retrograde cardioplegia perfusion (11,12). The aim of cardiac resynchronization therapy is to restore the synchronization between right and left ventricles.…”

mentioning

confidence: 99%

“…Catheter-based venous angiography is an invasive method with the potential for serious complications. Even when this method is used, the anatomy could not always be visualized (12). Even experienced centers have a failure rate of 5%-12% (13).…”

mentioning

confidence: 99%

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Assessment of the coronary venous system by using cardiac CT

Genç

Solak²,

Şahin³

et al. 2013

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to investigate the coronary venous system and its variations by using dual source computed tomography (CT). MATERIALS AND METHODSRetrospective assessment was carried out on 339 patients who underwent coronary CT angiography using 128-slice dual source CT for suspected coronary artery disease. The examinations were performed according to routine imaging protocols used to evaluate coronary arteries. The coronary venous system was evaluated in each case using maximum intensity projection and volume rendering technique multiplanar reformation reconstructions. In each patient, the presence and calibration of normal anatomy, as well as the variations of the coronary sinus, middle cardiac vein, small cardiac vein, posterior cardiac vein, great cardiac vein, anterior interventricular vein, posterolateral vein, left marginal vein, and anterolateral vein were recorded. RESULTSThe coronary sinus, middle cardiac vein, great cardiac vein, and anterior interventricular vein were visualized in all of the patients. In all cases, one of the lateral or posterolateral veins of appropriate localization and diameter for cardiac resynchronization therapy was detected. The posterior cardiac vein was visualized in 87% of the cases, the left marginal vein in 87.9%, and the small cardiac vein in 20%. There was no significant difference in the diameters or visibilities of the coronary veins in terms of age. CONCLUSIONThe coronary venous system and its tributaries may be examined in detail using CT angiography examination performed according to the routine coronary CT angiography protocol used for dual source CT. Dual source CT may be a valuable tool for evaluation of the coronary veins prior to invasive procedures that are directed at the coronary venous system.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Assessment of the coronary venous system by using cardiac CT

Genç

Solak²,

Şahin³

et al. 2013

Diagn Interv Radiol

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“…Until recently, exploring the CVS necessitated an invasive approach using RV, either by manual contrast injection or after occlusion of the CS [7,10,18,19].…”

Section: Discussionmentioning

confidence: 99%

Multidetector cardiac tomography: A useful tool before cardiac resynchronization therapy

et al. 2015

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Background: Left ventricular lead placement in a suitable coronary vein is a key determinant of responsiveness to cardiac resynchronization therapy (CRT). Multidetector cardiac tomography (MDCT) is a non-invasive alternative to depict cardiac venous anatomy although coronary sinus (CS) retrograde venography (RV) is the gold standard. The aim of this study was to evaluate the accuracy of MDCT to determine the presence of CS tributaries before CRT. Methods: A retrospective analysis of 41 consecutive patients eligible to CRT was performed. MDCT was assessed in all patients before CRT and RV was achieved in 39 patients. Both methods evaluated the presence of the inferior interventricular vein (IIV), posterior vein (PV) and lateral main vein (LMV). CS ostium diameter and distance between the CS ostium and and supero-inferior was 14.1 mm (p < 0.01). A positive correlation (p < 0.001) between echocardiographic RA area and the distance from CS ostium to the RA lateral wall in the MDCT was observed.

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“…Unfavorable CS or vein anatomy, such as CS dissection, occlusion, or abnormal ostium of the CS or focal coronary vein stenosis are the most frequent reasons. Post-implant dislocation of the lead, high pacing threshold or phrenic nerve stimulation also diminishes the effectiveness of LV stimulation [6][7][8]. In cases of unsuccessful LV lead placement through the CS, surgical epicardial lead implantation via a lateral thoracotomy or minimal-invasive thoracoscopy is considered the standard alternative method that requires general anesthesia [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Transseptal Leftventricular Endocardial Pacing is an Alternative Technique in Cardiac Resynchronization Therapy. One Year Experience in a High Volume Center

Neuhoff

Szilágyi

Molnár

et al. 2016

Romanian Journal of Internal Medicine

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Introduction. In patients receiving cardiac resynchronization therapy (CRT), failure rate to implant the left ventricular (LV) lead by the traditional trans-venous approach is 4-8%. Surgical epicardial implantation is considered as an alternative, but this technique is not without morbidity. Evidence from case documentation and from small trial batches demonstrated the viability of endocardial LV lead implantation where surgical epicardial lead placement is not applicable.Material and Methods. Four patients were implanted with endocardial LV lead using the transseptal atrial approach after unsuccessful transvenous implantation. Implantation of an endocardial active fixation LV leads was successful in all patients with stable electrical parameters immediately after implantation and over the follow-up period. All patients received anticoagulation therapy in order to target the international normalized ratio of 2.5-3.5 and have not experienced any thromboembolic, hemorrhagic events, or infection.Results. Follow-up echocardiography indicated significant improvement of LV systolic function (24 + 4.9 to 32 + 5.1 %, P = 0.023) with a notable improvement of the functional status.Conclusions. Endocardial left ventricular lead implantation can be a valuable and safe alternative technique to enable LV stimulation in high surgical risk patients where standard coronary sinus implant is unsuccessful.

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Investigation of Coronary Venous Anatomy by Retrograde Venography in Patients With Malignant Ventricular Tachycardia

Cited by 127 publications

References 11 publications

Assessment of the coronary venous system by using cardiac CT

Assessment of the coronary venous system by using cardiac CT

Multidetector cardiac tomography: A useful tool before cardiac resynchronization therapy

Transseptal Leftventricular Endocardial Pacing is an Alternative Technique in Cardiac Resynchronization Therapy. One Year Experience in a High Volume Center

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