Evaluation of the coronary venous system using electron beam computed tomography

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Cardiac Anatomy

Background:

• New therapeutic strategies in interventional cardiology and electrophysiology are increasingly involving the coronary veins.
• Accurate anatomical knowledge of the coronary venous system and its relationship with arteries is essential for procedural guidance.

Purpose of the Study:

• To evaluate the utility of electron beam computed tomography (EBCT) for noninvasive detailed definition of coronary venous anatomy.
• To assess arteriovenous relationships using EBCT in patients undergoing cardiac imaging.

Main Methods:

• Contrast-enhanced, thin-section EBCT coronary arteriographic images of 34 patients were analyzed.
• Two- and three-dimensional displays were used to qualitatively assess the visibility and spatial relationship of coronary veins to arteries.
• High spatial and temporal resolution of EBCT allowed imaging of the beating heart.

Main Results:

• The coronary sinus was visualized in 91% of patients, and the great cardiac vein in 100%.
• Anterior interventricular vein (97%) and veins on the left ventricle surface (97%) were highly visible.
• Specific relationships, like the anterior interventricular vein running parallel to the left anterior coronary artery (79%), were detailed.

Conclusions:

• Contrast-enhanced EBCT provides valuable noninvasive information on the coronary venous system and arteriovenous relationships.
• This detailed anatomical data may assist in guiding novel interventional procedures in cardiology and electrophysiology.