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[Coronary CTA evaluation of the relationship between mitral valve annulus and coronary circulation: implications for

K Warin-Fresse1, J Isnard, P Guérin

  • 1Centre Hémodynamique et Vasculaire Interventionnel, Institut du Thorax, CHU Nantes, Hôpital GR, Laennec 44093 Nantes Cedex 1. karine.warinfresse@chu-nantes.fr

Journal De Radiologie
|July 23, 2009
PubMed

Insights

Coronary CTA helps identify patients suitable for percutaneous mitral annuloplasty by evaluating anatomical relationships. Overlapping coronary sinus and arteries pose a risk of compression during the procedure.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Anatomy

Background:

  • Percutaneous mitral annuloplasty via the coronary sinus is a novel procedure.
  • Accurate anatomical assessment is crucial to avoid coronary artery occlusion.

Purpose of the Study:

  • To evaluate anatomical relationships between the mitral annulus (MA), coronary arteries, and coronary sinus (CS).
  • To identify candidates for percutaneous mitral annuloplasty via the CS.
  • To assess risks of coronary artery occlusion during the procedure.

Main Methods:

  • Retrospective review of 51 ECG-gated coronary CTA examinations.
  • Comparison of MA diameter, CS-coronary artery relationships, and MA-CS distance between groups with and without mitral insufficiency.

Main Results:

  • The mitral annulus was significantly larger in patients with mitral insufficiency.
  • In 70.4% of cases, the CS overlapped with a coronary artery, indicating a risk.
  • The distance between MA and CS was significantly greater posteriorly than laterally, persisting in both groups.

Conclusions:

  • Coronary CTA is valuable for selecting candidates for percutaneous mitral annuloplasty.
  • The high rate of CS-coronary artery overlap highlights the risk of compression during annuloplasty.
Abstract

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