Spatial relationship between the pulmonary trunk and the left coronaries: Systematic risk assessment based on automated three-dimensional distance measurementsKey Findings
| Autor: | Janek Salatzki, Florian Andre, Eberhard P. Scholz, Tobias Weber, Patrick Lugenbiel, Felix Bernhardt, Sebastian Sager, Johannes Riffel, Hugo A. Katus, Christa Hartlage |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology Ablation 519.6 03 medical and health sciences Clinical Spatial relationship Coronary arteries 0302 clinical medicine Ventricular arrhythmias Pulmonary trunk Internal medicine medicine Ventricular outflow tract Diseases of the circulatory (Cardiovascular) system Pulmonary Trunk 030212 general & internal medicine Sinus (anatomy) Coronary damage Risk assessment Right ventricular outflow tract 2. Zero hunger business.industry Pulmonary sinus cusps medicine.anatomical_structure Pulmonary valve RC666-701 Cardiology Cusp (anatomy) business |
| Zdroj: | Heart Rhythm O2, Vol 1, Iss 1, Pp 14-20 (2020) Heart Rhythm O2 |
| ISSN: | 2666-5018 |
| Popis: | Background Catheter ablation of right ventricular outflow tract ventricular arrhythmias from above the pulmonary valve is being increasingly reported. Objective The purpose of this study was to systematically analyze the spatial relationship between the pulmonary trunk and the left coronaries. Methods Contrast-enhanced computed tomographic scans from 58 patients were analyzed. After segmentation of the pulmonary trunk and the proximal left coronaries, 3-dimensional geometries were generated. Minimal distance between the pulmonary trunk and the coronaries was automatically determined using a newly developed mathematical algorithm. Results The minimal distance between the pulmonary trunk and the coronaries was 1.4 ± 0.11 mm. Closest relationship was detected 13.8 ± 0.87 mm above the pulmonary valve annulus. Considering a safety margin of 5 mm to render coronary damage unlikely, 84% of patients were found to be at potential risk within the bottom 10 mm of the left sinus cusp. In contrast, positions within or above the right and anterior cusps were less likely to exhibit a close relationship. We identified the anterior aspect of the left cusp as the most critical region. Positions 10–20 mm above the left cusp were found to be critical in 97% of patients. Clinical parameters such as gender, age, height, weight, and body mass index were not predictive of a close spatial relationship. Conclusion Our data provide evidence for a close spatial relationship between the pulmonary trunk and coronary arteries. These results should be considered when performing catheter ablation from above the pulmonary valve. |
| Databáze: | OpenAIRE |
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