Non-invasive cardiac vein mapping: role of MDCT-CA

Purpose: Coronary venous anatomy is of primary importance when implanting a pacemaker or a defibrillator device because coronary sinus can be enlarged or stenotic depending on chronic heart failure. The aim of this study is to evaluate the usefulness of MDCT-CA in describing the coronary venous tree and in particular the coronary sinus and detecting main venous system variants. Methods and Materials: 301 consecutive patients (196, mean age 63.74 YO) studied for coronary artery disease with 64 slice MDCT-CA were retrospectively examined. The cardiac venous system was depicted using 3D, MPR, cMPR and MIP post-processing reconstructions on an offline workstation. For each patient image quality, presence and calibre of the coronary sinus (CS), great cardiac vein (GCV), middle vein (MV), anterior interventricular vein (AIV), lateral cardiac vein (LCV), posterior cardiac vein (PCV), small cardiac vein (SCV) and presence of variant of the normal anatomy were recorded. Results and Conclusion: CS, GCV, MV and AIV were visualised in 100 % of the cases. The LCV was visualised in 255/301 (84%) patients, the PCV in 248/301 (83%) patients and the SCV in 69/301 (23%) patients. Mean diameter of the CS was 8.69 mm in 276/301 (91,7%) patients without chronic heart failure and 9.93 mm in 25/301 (8.3%) patients chronic heart failure