ABSTRACT Background:The coronary venous system is increasingly targeted for pacing in patients with severe heart failure. The recent advancement of Multi-Detector Computed Tomography (MDCT) allows accurate analysis of the coronary arteries, but little data exist on its role in assessing cardiac venous anatomy. The aim of the present study was to investigate the feasibility of using MDCT in evaluating the cardiac venous anatomy in patients with heart disease; Methods and Results: One hundred and eighteen subjects (59 ± 11 years, 100 males) were studied by contrast enhanced 16-slice CT with retrospective ECG-reconstructions. The diameter, length, and angulations of coronary veins were measured from both volume rendered 3-dimensional images and curved multi-planar images. The coronary sinus vein was visualized in all of patients. However, the posterior, postero-lateral, lateral, antero-lateral and anterior veins were found in 71.2%, 50.0%, 65.3%, 9.3% and 96% patients, respectively. Twenty-three (19.5%) subjects had neither postero-lateral nor lateral cardiac veins. The ostial diameter angle of take-off and total length of the postero-lateral and lateral veins ranged from 1.7 - 7.0 mm, 38 - 160 degrees and 2.6 - 10.6 mm, respectively; Conclusions: This study confirms the feasibility of assessing diameter, length, and angulations of coronary veins by MDCT. This non-invasive information should be useful for pre-operative lead placement planning for patients scheduled to have cardiac resynchronization therapy.
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J. Sun, X. Yang, Y. Lam, M. Garcia and C. Yu, "Evaluation of Coronary Venous Anatomy by Multislice Computed Tomography," World Journal of Cardiovascular Surgery, Vol. 2 No. 4, 2012, pp. 91-95. doi: 10.4236/wjcs.2012.24018.
 A. F. Kopp, S. Schroeder, A. Kuettner, A. Baumbach, C. Georg, R. Kuzo, et al., “Non-Invasive Coronary Angiography with High Resolution Multidetector-Row Computed Tomography. Results in 102 Patients,” European Heart Journal, Vol. 23, No. 21, 2002, pp. 1714-1725.
 K. Nieman, M. Oudkerk, B. J. Rensing, P. van Ooijen, A. Munne, R. J. van Geuns, et al., “Coronary Angiography with Multi-Slice Computed Tomography,” Lancet, Vol. 357, No. 9256, 2001, pp. 599-603.
 S. Achenbach, T. Giesler, D. Ropers, S. Ulzheimer, H. Derlien, C. Schulte, et al., “Detection of Coronary Artery Stenoses by Contrast-Enhanced, Retrospectively Electrocardiographically-Gated, Multislice Spiral Computed Tomography,” Circulation, Vol. 103, No. 21, 2001, pp. 2535-2538. doi:10.1161/01.CIR.103.21.2535
 K. Nieman, F. Cademartiri, P. A. Lemos, R. Raaijmakers, P. M. Pattynama and P. J. de Feyter, “Reliable Noninvasive Coronary Angiography with Fast Submillimeter Multislice Spiral Computed Tomography,” Circulation, Vol. 106, No. 16, 2002, pp. 2051-2054.
 M. Heuschmid, A. Kuttner, T. Flohr, J. E. Wildberger, M. Lell, A. F. Kopp, et al., “Visualization of Coronary Arteries in CT as Assessed by a New 16 Slice Technology and Reduced Gantry Rotation Time: First Experiences,” Rofo, Vol. 174, No. 6, 2002, pp. 721-724.
 T. Flohr, H. Bruder, K. Stierstorfer, J. Simon, S. Schaller and B. Ohnesorge, “New Technical Developments in Multislice CT, Part 2: Sub-Millimeter 16-Slice Scanning and Increased Gantry Rotation Speed for Cardiac Imaging,” Rofo, Vol. 174, No. 8, 2002, 1022-1027.
 C. Stellbrink, B. Diem, P. Schauerte, K. Ziegert and P. Hanrath, “Transcoronary Venous Radiofrequency Catheter Ablation of Ventricular Tachycardia,” Journal of Cardiovascular Electrophysiology, Vol. 8, No. 8, 1997, pp. 916-921. doi:10.1111/j.1540-8167.1997.tb00853.x
 R. Cappato, M. Schlüter, C. Weiss, S. Willems, T. Meinertz and K. H. Kuck, “Mapping of the Coronary Sinus and Great Cardiac Vein Using a 2-French Electrode Catheter and a Right Femoral Approach,” Journal of Cardiovascular Electrophysiology, Vol. 8, No. 4, 1997, pp. 371-376. doi:10.1111/j.1540-8167.1997.tb00802.x
 P. R. Roberts, J. F. Urban, T. Betts, S. Allen, A. Dietz, D. E. Euler, et al., “Reduction in Defibrillation Threshold Using an Auxiliary Shock Delivered in the Middle Cardiac Vein,” Pacing and Clinical Electrophysiology, Vol. 23, No. 8, 2000, pp. 1278-1282. doi:10.1111/j.1540-8159.2000.tb00944.x
 A. R. Leon, W. T. Abraham, S. Brozena, J. P. Daubert, W. G. Fisher, J. C. Gurley, et al., “Cardiac Resynchronization with Sequential Biventricular Pacing for the Treatment of Moderate-to-Severe Heart Failure,” Journal of the American College of Cardiology, Vol. 46, No. 12, 2005, pp. 2298-2304. doi:10.1016/j.jacc.2005.08.032
 A. Auricchio, C. Stellbrink, C. Butter, S. Sack, J. Vogt, A. R. Misier, et al., “Pacing Therapies in Congestive Heart Failure II Study Group. Guidant Heart Failure Research Group. Clinical Efficacy of Cardiac Resynchronization Therapy Using Left Ventricular Pacing in Heart Failure Patients Stratified by Severity of Ventricular Conduction Delay,” Journal of the American College of Cardiology, Vol. 42, No. 12, 2003, pp. 2109-2116.
 W. T. Abraham, W. G. Fisher, A. L. Smith, D. B. Delurgio, A. R. Leon, E. Loh, et al., “Cardiac Resynchronization in Chronic Heart Failure,” The New England Journal of Medicine, Vol. 346, No. 24, 2002, pp. 1845-1853.
 D. Gras, P. Mabo, T. Tang, O. Luttikuis, R. Chatoor, A. K. Pedersen, et al., “Multisite Pacing as a Supplemental Treatment of Congestive Heart Failure: Preliminary Results of the Medtronic InSync study. Pacing and Clinical Electrophysiology, Vol. 21, No. 11, 1998, pp. 2249-2255.
 R. Manzke, M. Grass, T. Nielsen, G. Shechter and D. Hawkes, “Adaptive Temporal Resolution Optimization in Helical Cardiac Cone Beam CT Reconstruction,” Medical Physics, Vol. 30, No. 12, 2003, pp. 3072-3080.
 T. C. Gerber, P. F. Sheedy, M. R. Bell, D. L. Hayes, J. A. Rumberger, T. Behrenbeck, et al., “Evaluation of the Coronary Venous System Using Electron Computed Tomography,” The International Journal of Cardiovascular Imaging, Vol. 17, No. 1, 2001, pp. 65-75.
 G. J. Schaffler, R. Groell, K. H. Peichel and R. Rienmuller, “Imaging the Coronary Venous Drainage System Using Electron-Beam CT,” Surgical and Radiologic Anatomy, Vol. 22, No. 1, 2000, pp. 35-39.
 F. M. Merchant, et al., “Impact of Segmental Left Ventricle Lead Position on Cardiac Resynchronization Therapy Outcomes,” Heart Rhythm, Vol. 7, No. 5, 2010. pp. 639-644.
 J. P. Singh, H. U. Klein, D. T. Huang, S. Reek, M. Kuniss, A. Quesada, A. Barsheshet, D. Cannom, I. Goldenberg, S. McNitt, J. P. Daubert, W. Zareba and A. J. Moss, “Left Ventricular Lead Position and Clinical Outcome in the Multicenter Automatic Defibrillator Implantation Trial Cardiac Resynchronization Therapy (MADIT-CRT) Trial,” Circulation, Vol. 123, No. 11, 2011, pp. 1159-1166.
 S. Cazeau, C. Leclercq, T. Lavergne, S. Walker, C. Varma, C. Linde, et al., “Effects of Multisite Biventricular Pacing in Patients with Heart Failure and Intraventricular Conduction Delay,” The New England Journal of Medicine, Vol. 344, No. 12, 2001, pp. 873-880.
 J. H. Artrip, D. Sukerman, M. L. Dickstein and H. M. Spotnitz, “Transesophageal Echocardiography Guided Placement of a Coronary Sinus Pacing Lead,” The Annals of Thoracic Surgery, Vol. 74, No. 4, 2002, pp. 1254-1256.