Assessment of the coronary venous system in heart failure patients by blood pool agent enhanced whole-heart MRI.
OBJECTIVE
To investigate the feasibility of MRI for non-invasive assessment of the coronary sinus (CS) and the number and course of its major tributaries in heart failure patients.


METHODS
Fourteen non-ischaemic heart failure patients scheduled for cardiac resynchronisation therapy (CRT) underwent additional whole-heart coronary venography. MRI was performed 1 day before device implantation. The visibility, location and dimensions of the CS and its major tributaries were assessed and the number of potential implantation sites identified. The MRI results were validated by X-ray venography conventionally acquired during the device implantation procedure.


RESULTS
The right atrium (RA), CS and mid-cardiac vein (MCV) could be visualised in all patients. 36% of the identified candidate branches were located posterolaterally, 48% laterally and 16% anterolaterally. The average diameter of the CS was quantified as 9.8 mm, the posterior interventricular vein (PIV) 4.6 mm, posterolateral segments 3.3 mm, lateral 2.9 mm and anterolateral 2.9 mm. Concordance with X-ray in terms of number and location of candidate branches was given in most cases.


CONCLUSIONS
Contrast-enhanced MRI venography appears feasible for non-invasive pre-interventional assessment of the course of the CS and its major tributaries.
Manzke
Robert
R
Department of Internal Medicine II, University Hospital of Ulm, Ulm, Germany. robert.manzke@philips.com
Binner
Ludwig
L
Bornstedt
Axel
A
Merkle
Nico
N
Lutz
Anja
A
Gradinger
Robert
R
Rasche
Volker
V
D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods; D015331:Cohort Studies; D003287:Contrast Media / Q000494:pharmacology; D017023:Coronary Angiography / Q000379:methods; D003331:Coronary Vessels / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D005682:Gadolinium / Q000494:pharmacology; D006325:Heart Atria / Q000473:pathology; D006333:Heart Failure / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds / Q000494:pharmacology; D010690:Phlebography / Q000379:methods; D014965:X-Rays
D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium