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Updated: Jul 19, 2026
Anatomical Reconstructions of the Human Cardiac Venous System using Contrast-computed Tomography of Perfusion-fixed Specimens
Published on: April 18, 2013
Non-invasive visualization of the cardiac venous system in coronary artery disease patients using 64-slice computed
Nico R Van de Veire1, Joanne D Schuijf, Johan De Sutter
1Department of cardiology, Leiden University Medical Center, Leiden, The Netherlands. nico.vandeveire@ugent.be
Insights
64-slice CT imaging can visualize cardiac veins, revealing anatomical variations. Patients with infarction history show fewer left marginal veins, potentially complicating cardiac resynchronization therapy lead placement.
Area of Science:
- Cardiovascular imaging
- Anatomical variations
- Cardiac electrophysiology
Background:
- Cardiac resynchronization therapy (CRT) improves outcomes for selected heart failure patients.
- Successful left ventricular lead implantation in CRT depends on venous anatomy knowledge.
Purpose of the Study:
- To assess the utility of 64-slice computed tomography (CT) for visualizing cardiac veins.
- To investigate the relationship between cardiac venous anatomical variations and a history of myocardial infarction.
Main Methods:
- 100 individuals underwent 64-slice CT scans.
- Subjects were categorized into control, coronary artery disease (CAD), and infarction history groups.
- Evaluated coronary sinus tributaries: posterior interventricular vein (PIV), posterior vein of the left ventricle, and left marginal vein (LMV).
Main Results:
- Coronary sinus and PIV were universally identified.
- Posterior vein of the left ventricle was observed in 82-96% of subjects.
- Left marginal vein (LMV) was significantly less frequent in patients with infarction history (27%) compared to controls (71%) and CAD patients (61%).
Conclusions:
- 64-slice CT enables non-invasive cardiac vein evaluation, highlighting significant anatomical variability.
- Reduced prevalence of LMV in infarction patients may impede optimal left ventricular lead placement for CRT.
- Understanding venous anatomy is crucial for personalized CRT candidate selection.
Objectives:
This study was designed to evaluate the value of 64-slice computed tomography (CT) to visualize the cardiac veins and evaluate the relation between variations in venous anatomy and history of infarction.
Background:
Cardiac resynchronization therapy (CRT) is an attractive treatment for selected heart failure patients. Knowledge of venous anatomy may help in identifying candidates for successful left ventricular lead implantation.
Methods:
The 64-slice CT of 100 individuals (age 61 +/- 11 years, 68% men) was studied. Subjects were divided into 3 groups: 28 control patients, 38 patients with significant coronary artery disease (CAD), and 34 patients with a history of infarction. Presence of the following coronary sinus (CS) tributaries was evaluated: posterior interventricular vein (PIV), posterior vein of the left ventricle, and left marginal vein (LMV). Vessel diameters were also measured.
Results:
Coronary sinus and PIV were identified in all individuals. Posterior vein of the left ventricle was observed in 96% of control patients, 84% of CAD patients, and 82% of infarction patients. In patients with a history of infarction, a LMV was significantly less observed as compared with control patients and CAD patients (27% vs. 71% and 61%, respectively, p < 0.001). None of the patients with lateral infarction and only 22% of patients with anterior infarction had a LMV. Regarding quantitative data, no significant differences were observed between the groups.
Conclusions:
Non-invasive evaluation of cardiac veins with 64-slice CT is feasible. There is considerable variation in venous anatomy. Patients with a history of infarction were less likely to have a LMV, which may hamper optimal left ventricular lead positioning in CRT implantation.
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