Non invasive cardiac vein mapping: role of mdct-ca

Purpose: Coronary venous anatomy is of primary importance when implanting a pacemaker or a defibrillator device because coronary sinus can be enlarged (or stenotic) depending on chronic heart failure. The aim of this study is to evaluate the usefulness of MDCT-CA in describing the coronary venous tree and in particular the coronary sinus and detecting main venous system variants. Methods and Materials: 515 consecutive patients (318 ♂, mean age 62.5 YO) studied for coronary artery disease with 64 slice MDCT-CA were retrospectively examined. The cardiac venous system was depicted using 3D, MPR, cMPR and MIP post-processing reconstructions on an off-line workstation. For each patient image quality, presence and caliber of the coronary sinus (CS), great cardiac vein (GCV), middle vein (MV), anterior interventricular vein (AIV), lateral cardiac vein (LCV), posterior cardiac vein (PCV), small cardiac vein (SCV) and presence of variant of the normal anatomy were recorded. Results: CS, GCV, MV and AIV were visualized in 100 % of the cases. The LCV was visualized in 341/515 patients (66.2%), the PCV in 382/515 patients (74.1%) and the SCV in 168/515 (32.6%) patients. Mean diameter of the CS was 4.5 mm in 392/515 patients without chronic heart failure and 5.8 mm in 123/515 (23.8%) patients chronic heart failure. Conclusion: MDCT-CA allows non invasive mapping for the cardiac venous system and it is a useful tool for pre surgical implants of pacemakers or defibrillators.