Anatomic characteristics of left atrium and openings of pulmonary veins

İkiz, Z. Aslı Aktan; Üçerler, Hülya; Özgür, T.

doi:10.5152/akd.2014.4968

Cited by 13 publications

(8 citation statements)

References 16 publications

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“…The typical anatomy of right and left PV are two separate ostia on each side, this was true in our series in more than 66% on the right and almost 82% on the left, comparing to literature data where the typical anatomy of right PV was observed in 60–88% and of left PV in 41–91% [ 1 , 23 , 28 , 32 ]. A common trunk was more frequent on the left (17.8%) than on the right (4%), which is similar to most of the literature data: 6–33% [ 1 , 17 , 18 , 23 , 28 ] and 0.76–4%, respectively [ 3 , 5 , 17 , 32 ].…”

Section: Discussionsupporting

confidence: 89%

Morphology and morphometry of pulmonary veins and the left atrium in multi-slice computed tomography

Polaczek

Szaro

Barańska³

et al. 2019

Surg Radiol Anat

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Purpose Pulmonary veins are involved in pathogenesis and treatment of atrial fibrillation and structures at risk during thoracic surgeries. There is lack of data regarding pulmonary vein morphology and morphometry in normal population. Methods The study was conducted using 135 chest computed tomography studies with intra-venous iodine contrast injection. The study population contained 86 females and 49 males, mean age was 60. 13 had atrial fibrillation. The studies were analyzed using radiological workstation. Results Mean dimensions of the left atrium: transverse 52 mm, coronal 49 mm, and sagittal 35 mm. The mean volume of the left atrium was 93 cm 3 . The mean volume of the left atrium in patients with atrial fibrillation was 176 cm 3 . The sagittal dimension and the volume of the left atrium were correlated with age, r = 0.43 and r = 0.42, respectively. Surface area of the left inferior pulmonary vein ostium was 136 mm 2 , significantly less than the surface area of other ostia of pulmonary veins. The mean distance between two pulmonary veins was 5.42 mm on the right and 4.02 mm on the left side. 13 types of pulmonary veins outflow patterns were described on the right side and 5 types on the left side. 66.7% of right pulmonary veins and 82% of the left pulmonary veins emptied into the left atrium with two venous trunks on each side (the typical pattern). Conclusions Morphological features of pulmonary veins and morphometry of the left atrium and pulmonary veins are important for clinical purposes and are in accordance with previous papers.

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Section: Discussionsupporting

confidence: 89%

Morphology and morphometry of pulmonary veins and the left atrium in multi-slice computed tomography

Polaczek

Szaro

Barańska³

et al. 2019

Surg Radiol Anat

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“…Also, McLellan et al noticed the classical pattern and the left common PV ostium in 47% and 37% of AF patients respectively; they also concluded that the presence of the left common PV was associated with an increased freedom from AF after catheter ablation (assessed by using Cox regression analysis in univariate and multivariate models) ( McLellan et al, 2014 ). In conclusion, we can note a trend that the common left PV ostia are more frequently found in AF patients, while in the normal population they are the minor variation (up to 15%) ( Aktan Ikiz, Üçerler & Özgür, 2014 ; Woźniak-Skowerska et al, 2011 ). Isolation of such small ostia entails much higher risk of PV stenosis caused by catheter ablation.…”

Section: Discussionmentioning

confidence: 62%

“…There is no doubt that the clinical importance of pulmonary vein anatomy is crucial for planning and performing the catheter and balloon-based pulmonary vein ablation (isolation) procedures ( Aktan Ikiz, Üçerler & Özgür, 2014 ; Köse et al, 2012 ; Mayor, 2015 ; Nalliah et al, 2015 ; Rettmann et al, 2015 ; Sarabanda et al, 2005 ; Stanford & Breen, 2005 ). Classical 4 PV ostia pattern could be observed in 68–81% of all individuals ( Aktan Ikiz, Üçerler & Özgür, 2014 ; Kaseno et al, 2008 ; L C et al, 2014 ; Marom et al, 2004 ; Scharf et al, 2003 ; Tekbas et al, 2012 ). The present study confirms that a common PV ostium occurring on the left side is the most frequent anatomical variation in the healthy population, whereas an additional ostium is most common on the right side of the left atrium ( Prasanna et al, 2014 ; Stanford & Breen, 2005 ; Vasamreddy et al, 2004 ; Woźniak-Skowerska et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Normal distal pulmonary vein anatomy

Klimek‐Piotrowska

Hołda

Piątek

et al. 2016

PeerJ

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Background. It is well known that the pulmonary veins (PVs), especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants.Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian) were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated.Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs) were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%), followed by the common ostium for the left superior and the inferior PVs (4.44%). Mean diameters of PV ostia (for the classical pattern) were: left superior = 13.8 ± 2.9 mm; left inferior = 13.3 ± 3.4 mm; right superior = 14.3 ± 2.9 mm; right inferior = 13.7 ± 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 ± 4.1 mm). The mean ostium-to-last-tributary (closest to the atrium) distances were: left superior = 15.1 ± 4.6 mm; left inferior = 13.5 ± 4.0 mm; right superior = 11.8 ± 4.0 mm; right inferior = 11.0 ± 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances.Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs.

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“…In general, the anatomical variations of PV ostia were examined in 73 studies including 13,811 subjects (Abadir et al, 2019; Akkaya et al, 2018; Aktan Ikiz et al, 2014; Allgayer et al, 2008; Altinkaynak & Koktener, 2019; Angulo Hervias et al, 2020; Anselme et al, 2006; Anselmino et al, 2011; Artuso et al, 2005; Baszko et al, 2012; Benini et al, 2008; Beukema et al, 2010; Bittner et al, 2011; Boersma et al, 2008; Bogot et al, 2009; Bourier et al, 2013; Brunelli et al, 2012; Carreras et al, 2005; Chen et al, 2017; Cirillo et al, 2004; Cronin et al, 2007; Dong et al, 2005, 2006; Fodi et al, 2013; Hamdan et al, 2009; Harbi et al, 2014; Hauser et al, 2006, 2015; Hof et al, 2009; Hoffmeister et al, 2007; Huang et al, 2018; Hunter et al, 2010; Ihara et al, 2011; Imanli et al, 2017; Istratoaie et al, 2019; Jongbloed et al, 2004; Jongbloed, Bax, et al, 2005; Jongbloed, Dirksen, et al, 2005; Kanaji et al, 2016; Kaseno et al, 2008; Klimek‐Piotrowska et al, 2016; Knecht et al, 2013; Koçyiğit et al, 2017; Krum et al, 2013; Kubala et al, 2011; Lickfett et al, 2004, 2005; Mansour et al, 2004; Martinez Urabayen et al, 2021; Merchant et al, 2016; Metzner et al, 2012; Micochova et al, 2005; Mulder et al, 2011; Niculescu et al, 2006; Patel et al, 2013; Pontone et al, 2015; Prasanna et a...…”

Section: Resultsmentioning

confidence: 99%

Variations in human pulmonary vein ostia morphology: A systematic review with meta‐analysis

et al. 2022

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This study aimed to establish the most accurate and up‐to‐date anatomical knowledge of pulmonary veins (PV), ostia variations, diameters and ostial area, to provide physicians, especially heart and thoracic surgeons with exact knowledge concerning this area. The main online medical databases, such as PubMed, Embase, Scopus, Web of Science, and Google Scholar, were searched to gather all studies in which the variations, maximal diameter, and ostial area of the PVs were investigated. During the study, the preferred reporting items for systematic reviews and meta‐analyses (PRISMA) guidelines were followed. Additionally, the critical appraisal tool for anatomical meta‐analysis (CATAM) was used to provide the highest quality findings. The most common ostia variation is the classical one, which contains the left superior pulmonary vein (LSPV), left inferior pulmonary vein (LIPV), right superior pulmonary vein (RSPV) and right inferior pulmonary vein (RIPV). The mean diameter and ostial area of each pulmonary vein were established in the general population and in multiple variations considering the method of collecting the data and geographical location. Significant variability in PV ostia is observed. Left‐sided PVs have smaller ostia than the corresponding right‐sided PVs, and the inferior PVs ostia are smaller than the superior. The LCPV ostium size is the largest among all veins analyzed, while the RMPV ostium is the smallest. The results of this meta‐analysis are hoped to help clinicians in planning and performing procedures that involve the pulmonary and cardiac areas, especially catheter ablation for atrial fibrillation.

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Anatomic characteristics of left atrium and openings of pulmonary veins

Cited by 13 publications

References 16 publications

Morphology and morphometry of pulmonary veins and the left atrium in multi-slice computed tomography

Morphology and morphometry of pulmonary veins and the left atrium in multi-slice computed tomography

Normal distal pulmonary vein anatomy

Variations in human pulmonary vein ostia morphology: A systematic review with meta‐analysis

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