Background:The coronary venous system is increasingly targeted for pacing in patients with severe heart failure. The recent advancement of Multi-Detector Computed Tomography (MDCT) allows accurate analysis of the coro...Background:The coronary venous system is increasingly targeted for pacing in patients with severe heart failure. The recent advancement of Multi-Detector Computed Tomography (MDCT) allows accurate analysis of the coronary arteries, but little data exist on its role in assessing cardiac venous anatomy. The aim of the present study was to investigate the feasibility of using MDCT in evaluating the cardiac venous anatomy in patients with heart disease;Methods and Results: One hundred and eighteen subjects (59 ± 11 years, 100 males) were studied by contrast enhanced 16-slice CT with retrospective ECG-reconstructions. The diameter, length, and angulations of coronary veins were measured from both volume rendered 3-dimensional images and curved multi-planar images. The coronary sinus vein was visualized in all of patients. However, the posterior, postero-lateral, lateral, antero-lateral and anterior veins were found in 71.2%, 50.0%, 65.3%, 9.3% and 96% patients, respectively. Twenty-three (19.5%) subjects had neither postero-lateral nor lateral cardiac veins. The ostial diameter angle of take-off and total length of the postero-lateral and lateral veins ranged from 1.7 - 7.0 mm, 38 - 160 degrees and 2.6 - 10.6 mm, respectively;Conclusions: This study confirms the feasibility of assessing diameter, length, and angulations of coronary veins by MDCT. This non-invasive information should be useful for pre-operative lead placement planning for patients scheduled to have cardiac resynchronization therapy.展开更多
目的对比经颈静脉肝内门体分流术(TIPS)联合胃冠状静脉栓塞术(GCVE)与单纯TIPS治疗肝硬化门静脉高压症上消化道出血(UGH)的临床疗效。方法计算机和人工检索PubMed、Cochrane Library、Web of Science、CBM、万方数据库及中国知网收录的...目的对比经颈静脉肝内门体分流术(TIPS)联合胃冠状静脉栓塞术(GCVE)与单纯TIPS治疗肝硬化门静脉高压症上消化道出血(UGH)的临床疗效。方法计算机和人工检索PubMed、Cochrane Library、Web of Science、CBM、万方数据库及中国知网收录的关于比较TIPS联合GCVE与单纯TIPS治疗门静脉高压伴UGH疗效的临床对照实验的文献报道,研究者从中提取相关资料,根据Cochrane手册标准对纳入文献的质量予以评价。结果最终8篇文献纳入研究,病例总数为690例。结果显示,TIPS联合GCVE组术后再出血率及肝性脑病发生率低于单纯TIPS组(OR=0.35,95%CI:0.24～0.53,P<0.00001;OR=0.50,95%CI:0.30～0.84,P=0.009);而在支架通畅率及术后总生存率方面差异无统计学意义(OR=1.05,95%CI:0.68～1.63,P=0.83;OR=1.16,95%CI:0.74～1.80,P=0.52)。结论 TIPS联合GCVE在降低术后再出血率及肝硬化门静脉高压症术后肝性脑病发生率方面较单纯TIPS有明显优势,在提高支架通畅率及术后总生存率方面无明显差异。展开更多
文摘Background:The coronary venous system is increasingly targeted for pacing in patients with severe heart failure. The recent advancement of Multi-Detector Computed Tomography (MDCT) allows accurate analysis of the coronary arteries, but little data exist on its role in assessing cardiac venous anatomy. The aim of the present study was to investigate the feasibility of using MDCT in evaluating the cardiac venous anatomy in patients with heart disease;Methods and Results: One hundred and eighteen subjects (59 ± 11 years, 100 males) were studied by contrast enhanced 16-slice CT with retrospective ECG-reconstructions. The diameter, length, and angulations of coronary veins were measured from both volume rendered 3-dimensional images and curved multi-planar images. The coronary sinus vein was visualized in all of patients. However, the posterior, postero-lateral, lateral, antero-lateral and anterior veins were found in 71.2%, 50.0%, 65.3%, 9.3% and 96% patients, respectively. Twenty-three (19.5%) subjects had neither postero-lateral nor lateral cardiac veins. The ostial diameter angle of take-off and total length of the postero-lateral and lateral veins ranged from 1.7 - 7.0 mm, 38 - 160 degrees and 2.6 - 10.6 mm, respectively;Conclusions: This study confirms the feasibility of assessing diameter, length, and angulations of coronary veins by MDCT. This non-invasive information should be useful for pre-operative lead placement planning for patients scheduled to have cardiac resynchronization therapy.
文摘目的对比经颈静脉肝内门体分流术(TIPS)联合胃冠状静脉栓塞术(GCVE)与单纯TIPS治疗肝硬化门静脉高压症上消化道出血(UGH)的临床疗效。方法计算机和人工检索PubMed、Cochrane Library、Web of Science、CBM、万方数据库及中国知网收录的关于比较TIPS联合GCVE与单纯TIPS治疗门静脉高压伴UGH疗效的临床对照实验的文献报道,研究者从中提取相关资料,根据Cochrane手册标准对纳入文献的质量予以评价。结果最终8篇文献纳入研究,病例总数为690例。结果显示,TIPS联合GCVE组术后再出血率及肝性脑病发生率低于单纯TIPS组(OR=0.35,95%CI:0.24～0.53,P<0.00001;OR=0.50,95%CI:0.30～0.84,P=0.009);而在支架通畅率及术后总生存率方面差异无统计学意义(OR=1.05,95%CI:0.68～1.63,P=0.83;OR=1.16,95%CI:0.74～1.80,P=0.52)。结论 TIPS联合GCVE在降低术后再出血率及肝硬化门静脉高压症术后肝性脑病发生率方面较单纯TIPS有明显优势,在提高支架通畅率及术后总生存率方面无明显差异。
