MSCT labelling for pre-operative planning in cardiac resynchronization therapy

Abstract

The objective of this paper is twofold: (i) to show how multislice computed tomography (MSCT) data sets bring the information required for cardiac resynchronisation therapy (CRT) planning; (ii) to demonstrate the feasibility of 3D navigation into the veins where left ventricular leads have to be placed. The former has been achieved by exploring and labelling the cardiac structures of concern, the latter has been performed by using the concept of virtual navigation with high resolution surface detection and estimation algorithms.

Non-Invasive Visualization of the Cardiac Venous System in Coronary Artery Disease Patients Using 64-Slice Computed Tomography

“…Depending on the experience of the implanting cardiologist, no invasive venography at all or only selected venography of the target cardiac vein may be sufficient to implant the lead successfully, on the basis of the MSCT data. In addition, information on cardiac venous anatomy acquired with MSCT could also be used during CRT implantation for 3-D navigation into the heart cavities and veins (26). …”

Fused Whole-Heart Coronary and Myocardial Scar Imaging Using 3-T CMR

“…The established and expanding role of CRT in patients with systolic heart failure is challenged by recognition of its limited or absent benefit in approximately one-third of patients (29,30). Therefore, although the use of anatomic vascular imaging to plan placement of CRT leads has been recently suggested (3)(4)(5), the ability to simultaneously visualize this anatomy in the context of myocardial scar greatly enhances the identification of optimal targets. Therefore, although the use of anatomic vascular imaging to plan placement of CRT leads has been recently suggested (3)(4)(5), the ability to simultaneously visualize this anatomy in the context of myocardial scar greatly enhances the identification of optimal targets.…”

“…Three-dimensional (3D) vascular imaging has been shown to be of value for identification of these targets (1)(2)(3)(4)(5). Both cardiac resynchronization therapy (CRT) and coronary artery revascularization (CAR) rely upon appropriate vascular targets in the venous and arterial circulations, respectively.…”

Posterior Shift of the Anterior Papillary Muscle in Patients With Heart Failure A Potential Role in the Effect of Cardiac Resynchronization Therapy

“…Terminology: We defined the LV branches of the coronary veins by segmental classification, which are common among electrocardiologists as follows. 12,13) Lateral vein: LV branches arise from lateral wall Posterolateral vein: LV branches arise from between the posterior wall and lateral wall Anatomic observations by MDCT: The raw MDCT data were transferred to an image analysis workstation (M900 Quadra, ZIOSOFT, Tokyo). As we can freely rotate the obtained images on volume-rendered reconstructions in this workstation, we can easily construct a conventional short-axis view at the mid-papillary muscle level (the level where the papillary muscle appeared thickest) showing a circular left ventricle without difference among observer's technique.…”