Investigation of coronary venous anatomy by retrograde venography in patients with malignant ventricular tachycardia
| Autor: | Stephen J. Hahn, Lothar Engelmann, Eckart Fleck, Dietrich Pfeiffer, Bernd Schubert, Jürgen Tebbenjohanns, Eckhard Meisel, Christian Butter |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Middle Cardiac Vein Venography Ventricular tachycardia Veins Physiology (medical) Internal medicine medicine Humans Vein Coronary sinus Aged Coronary Vein medicine.diagnostic_test business.industry Phlebography Middle Aged medicine.disease Coronary Vessels medicine.anatomical_structure Heart failure cardiovascular system Cardiology Tachycardia Ventricular Female Cardiology and Cardiovascular Medicine business Lower limbs venous ultrasonography |
| Zdroj: | Circulation. 104(4) |
| ISSN: | 1524-4539 |
| Popis: | Background The coronary venous system is increasingly used for left ventricular or biventricular pacing in patients with severe heart failure. The present study investigated the structure of the coronary veins in patients presenting with structural heart disease and malignant ventricular tachyarrhythmias. The availability of veins for possible lead placement was assessed. Methods and Results The number, relative size, and location of coronary veins were evaluated by retrograde venography in 129 patients undergoing cardioverter-defibrillator implantation. Detailed x-ray image analysis was performed in 86 patients, for whom optimal coronary sinus occlusion and vein visualization was achieved. The anterior interventricular vein and the middle cardiac vein were visible in 85 (99%) of 86 patients and in 86 (100%) of 86 patients, respectively. Between these 2 veins, at least 1 additional prominent vein was visible in 85 (99%) of 86 patients. Just 1 vein was present in 44 (51%) of 86 patients. Two veins were observed in 40 (46%) of 86 patients, and >2 veins were visualized in 2 (2%) of 86 patients. Venous anatomy allowed positioning of a 0.014-in guidewire in a coronary vein in 115 (93%) of 124 patients. Conclusions The presence, diameter, angulation, and tortuosity of veins as visualized by retrograde venography determine their acceptability for the placement of a lead in a predetermined location. Despite the considerable variability of the coronary venous system among patients, a lateral vessel for lead introduction was available in 82%, and a posterior or lateral vessel was available in 99% of individuals within a patient population that could potentially benefit from a lead on the left ventricle. |
| Databáze: | OpenAIRE |
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