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Imaging of the coronary venous system in patients with congestive heart failure: comparison of 16 slice MSCT and retrograde coronary sinus venography

Comparative imaging of coronary venous system
  • Christian Knackstedt
  • Georg Mühlenbruch
  • Karl Mischke
  • Thomas Schimpf
  • Elmar Spüntrup
  • Rolf W. Günther
  • Beyhan Sanli
  • Malte Kelm
  • Patrick Schauerte
  • Andreas H. Mahnken
Original Paper

Abstract

Background Knowledge of the anatomy of the coronary venous system (CVS) is important for planning of cardiac interventions like cardiac resynchronization therapy or percutaneus mitral annuloplasty. Different methods have been used for preprocedural visualization of the CVS. However, limited data is available comparing invasive retrograde coronary sinus angiography (CSA) and non-invasive multi slice computed tomography (MSCT). Thus, a comparison of retrograde CSA and ECG-gated MSCT for the visualization of the CVS in patients with congestive heart failure (CHF) was performed. Methods 20 patients (male: 11) with CHF underwent CSA and MSCT (16 × 0.75 mm collimation, tube voltage: 120 kV, tube current: 550 mAseff). Both methods were compared with respect to vessel diameter and visibility. Results Vessel visualization was better using retrograde CSA except for middle cardiac vein and small veins which were better seen with MSCT. Overall, there was a trend that MSCT detected more vessels. Vessel diameters were larger measured using retrograde CSA, but only statistically significant for the coronary sinus and middle cardiac vein. Conclusion Whereas MSCT is more suitable for an overview, retrograde CSA offers a more detailed visualization of the CVS including marginal and posterior veins than MSCT. Thus, retrograde CSA allows a better display of target vessels commonly used for cardiac interventions. Overall, these two imaging techniques offer complementary information.

Keywords

Congestive heart failure Coronary sinus angiography Coronary venous system MSCT 

Abbreviations

CHF

Congestive heart failure

CRT

Cardiac resynchronization therapy

CS

Coronary sinus

CSA

Coronary sinus angiography

CT

Computed tomography

CVS

Coronary venous system

ICD

Implantable cardioverter defibrillator

MSCT

Multi slice computed tomography

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Copyright information

© Springer Science+Business Media, B.V. 2008

Authors and Affiliations

  • Christian Knackstedt
    • 1
  • Georg Mühlenbruch
    • 2
  • Karl Mischke
    • 1
  • Thomas Schimpf
    • 1
  • Elmar Spüntrup
    • 2
  • Rolf W. Günther
    • 2
  • Beyhan Sanli
    • 2
  • Malte Kelm
    • 1
  • Patrick Schauerte
    • 1
  • Andreas H. Mahnken
    • 2
  1. 1.Department of Cardiology, Pneumology, Vascular Medicine, University HospitalRWTH Aachen UniversityAachenGermany
  2. 2.Department of Diagnostic Radiology, University HospitalRWTH Aachen UniversityAachenGermany

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