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[Angiography of the coronary venous system. Use in clinical electrophysiology]
W D Melo1, L A Prudencio, C E Kusnir
1Escola Paulista de Medicina, UNIFESP.
Insights
Coronary venous angiography using balloon occlusion is safe and feasible. Veins in the left ventricle
Area of Science:
- Cardiovascular anatomy
- Interventional cardiology
- Vascular imaging
Context:
- Understanding coronary venous anatomy is crucial for diagnosing and treating cardiac arrhythmias.
- Epicardial mapping requires detailed knowledge of venous structures.
- Sustained ventricular tachycardia (VT) often necessitates advanced diagnostic techniques.
Purpose:
- To investigate the angiographic anatomy of human coronary veins.
- To assess the feasibility of epicardial venous mapping using microelectrode catheters.
- To evaluate a novel balloon occlusion technique for coronary venous angiography.
Summary:
- A safe and feasible balloon occlusion technique for coronary venous angiography was employed in 30 patients with sustained ventricular tachycardia.
- Analysis revealed a significantly greater number and caliber of veins on the posterior wall compared to the anterior wall of the left ventricle.
- Specific measurements for the anterior interventricular, posterior interventricular, and left posterior veins were recorded.
Impact:
- The study demonstrates that the posterior wall of the left ventricle offers more suitable anatomical conditions for epicardial venous mapping.
- Findings provide critical anatomical data for guiding electrophysiological procedures.
- This technique enhances the safety and efficacy of diagnosing complex cardiac arrhythmias.
Purpose:
To study the angiographic anatomy of human coronary veins and the possibility of epicardial venous mapping through microelectrode catheters.
Methods:
We evaluated 30 patients with sustained ventricular tachycardia using a catheter which provided occlusion of the coronary sinus ostium during venous angiography. They were 25 males, 5 females, ages ranging from 24 to 76 years (mean = 52.7). The veins were studied according to their number, caliber and distribution in the anterior and posterior wall of the left ventricle.
Results:
Coronary sinus was catheterized in all patients. No discomfort or complication were observed. The number of veins from posterior wall of the left ventricle was 3.1 and anterior wall, 1.9, p < 0.05. The caliber of the coronary veins were: anterior interventricular vein (distal segment = 1.19 +/- 0.22 mm, middle segment = 1.65 +/- 0.35 mm), posterior interventricular vein (distal segment = 1.83 +/- 0.47 mm, middle segment = 2.00 +/- 0.52 mm), left posterior vein (distal segment = 1.45 +/- 0.25 mm, middle segment = 2.49 +/- 0.92 mm); p < 0.05.
Conclusion:
The balloon occlusion technique for coronary venous angiography is feasible and safe. The number and the caliber (distal and middle) of the veins from the posterior wall of the left ventricle were significantly greater than those from the anterior wall. Anatomic conditions for venous epicardial mapping are more adequate in the posterior wall of the left ventricle.