Document Detail


The role of cardiovascular computed tomographic angiography for coronary sinus mitral annuloplasty.
MedLine Citation:
PMID:  20124591     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The coronary sinus (CS) travels in close proximity to the left circumflex (LCX) artery. Percutaneously placed CS devices used to treat mitral regurgitation (MR) therefore have the potential to impinge upon the LCX arterial distribution and compromise coronary flow. OBJECTIVES: In this study, we sought to analyze the anatomic relationship between the CS, LCX and mitral annulus (MA) in patients with right dominant (RCD), left dominant (LCD) and codominant (CCD) arterial systems using a novel systematic approach. METHODS: We retrospectively studied 102 normal patients (46 females) and 27 consecutive patients (5 females) with ischemic severe MR. All patients underwent cardiovascular computed tomographic (CCT) angiography with a 64 multidetector scanner for clinical indications. Images were analyzed using a GE Advantage workstation, version 4.4, capable of advanced image processing and manipulation. RESULTS: In patients with a normal mitral valve, the LCX initially crossed under the coronary sinus/great cardiac vein (CS/GCV) in 74% with RCD, 83% with LCD and 97% with CCD. In patients with ischemic severe MR, the LCX initially crossed under the CS/GCV in 96%. CONCLUSIONS: The majority of patients, especially those with a CCD, have the LCX initially coursing under the CS/GCV. CCT data analysis using our newly established method is an excellent tool to evaluate the anatomic course of the LCX in patients being evaluated for percutaneous CS device placement.
Authors:
Ambarish Gopal; Atman Shah; Shahrzad Shareghi; Neeraj Bansal; Khurram Nasir; Deepika Gopal; Matthew J Budoff; David M Shavelle
Publication Detail:
Type:  Comment; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-04-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  67-73     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, Loma Linda University Medical Center, Loma Linda, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Balloon Dilatation / methods*
Coronary Sinus / anatomy & histology,  radiography*
Databases, Factual
Female
Humans
Male
Middle Aged
Mitral Valve / pathology,  radiography*
Mitral Valve Insufficiency* / pathology,  radiography,  therapy
Myocardial Ischemia / pathology,  radiography,  therapy
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed / instrumentation,  methods*
Comments/Corrections
Comment On:
J Invasive Cardiol. 2010 Feb;22(2):74-5   [PMID:  20124592 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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