Role of Multislice Computed Tomography for Preprocedural Evaluation Before Revision of a Chronically Implanted Transvenous Left Ventricular Lead
| Autor: | Tiziano Moccetti, Giovanni Pedrazzini, Elena Pasotti, Cristina Conca, Francesco Faletra, Angelo Auricchio, Jagmeet P. Singh, Antonio Sorgente, Francesco Siclari |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Heart Ventricles medicine.medical_treatment Cardiac resynchronization therapy Coronary Angiography Radiography Interventional Doppler imaging Internal medicine medicine Humans Vein Vascular Patency Coronary sinus Aged Aged 80 and over Heart Failure Coronary Vein medicine.diagnostic_test business.industry Cardiac Pacing Artificial Coronary Sinus Middle Aged medicine.disease Vein occlusion medicine.anatomical_structure Coronary Occlusion Heart failure Retreatment Angiography Cardiology Feasibility Studies Female Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 100:1566-1570 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2007.06.065 |
| Popis: | The purpose of this study was to determine the feasibility of multislice computed tomography (MSCT) to assess the coronary sinus (CS) and its tributaries in patients who are undergoing cardiac resynchronization therapy and need a left ventricular (LV) lead revision. Preprocedural imaging modality, which may enable delineation of the cardiac venous anatomy in patients who need LV lead replacement, has not yet been evaluated. Ten patients with heart failure with previously implanted cardiac resynchronization therapy devices, who presented with worsening heart failure, were studied with MSCT and tissue Doppler imaging echocardiography before LV lead replacement. MSCT was performed to evaluate patency of the CS and coronary veins, and tissue Doppler imaging echocardiography assessed the region and the magnitude of mechanical dyssynchrony. An excellent concordance in the vein diameter, location, and status between MSCT and angiography was found. Apart from the need to perform a venoplasty in 1 patient and an unsuccessful lead explantation in another patient, all other anatomic issues were correctly predicted by MSCT. CS or vein occlusion were present in 4 patients, and in 3 of them surgical LV lead replacement was performed. Identification of a patent venous system enabling successful transvenous lead implantation was possible in 2 patients. Direct visualization of the proximity of the target vein to the phrenic nerve and the diaphragm guided lead selection and position in 4 patients. In conclusion, MSCT may be used to delineate the coronary venous anatomy in patients in whom LV lead replacement is needed to help strategize whether a transvenous or transthoracic approach may be preferred for LV lead revision. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect