The role of the coronary venous system was underestimated for many years.In the last 20 years,a few percutaneous cardiology techniques in which the anatomy of the coronary venous system was significant were developed ...The role of the coronary venous system was underestimated for many years.In the last 20 years,a few percutaneous cardiology techniques in which the anatomy of the coronary venous system was significant were developed and are in use.The most important seems to be cardiac resynchronization therapy,which is an invasive method for the treatment of heart failure.Unfortunately,one of the major problems is the significant anatomical variability of the coronary venous system.The description of the selected anatomical structures is only useful in selected cases such as,for example,the obstruction of selected vessels,a huge Thebesian valve,etc.The 3D images can add significant value;however,their usefulness is limited due to the different points of view that are obtained during intra-operational fluoroscopy.After summarizing all of the articles andguidelines,it can be recommended that the visualization of the coronary venous system be performed in certain patients before cardiac resynchronization.The best option is to use tomography with retrospective gating with the optimal reconstruction of cardiac veins that occurs during the diastolic phases.展开更多
We are reporting a case of a 80-year-old lady with effort angina who underwent coronary angiography through the right radial artery, using a dedicated radial multipurpose 5 French Optitorque Tiger catheter. The cathet...We are reporting a case of a 80-year-old lady with effort angina who underwent coronary angiography through the right radial artery, using a dedicated radial multipurpose 5 French Optitorque Tiger catheter. The catheter was advanced into the left ventricle and a left ventriculogram was obtained, while the catheter appeared optimally placed at the centre of the ventricle and the pressure waveform was normal. A large posterior interventricular vein draining into the right atrium was opacified, presumably because the catheter's end hole inadvertently cannulated an endocardial opening of a small thebesian vein, with subsequent retrograde filling of the epicardial vein. Our case suggests that caution is needed when a dedicated radial catheter with both an end-hole and a side hole is used for a ventriculogram, as a normal left ventricular pressure waveform does not exclude malposition of the end-hole against the ventricular wall.展开更多
文摘The role of the coronary venous system was underestimated for many years.In the last 20 years,a few percutaneous cardiology techniques in which the anatomy of the coronary venous system was significant were developed and are in use.The most important seems to be cardiac resynchronization therapy,which is an invasive method for the treatment of heart failure.Unfortunately,one of the major problems is the significant anatomical variability of the coronary venous system.The description of the selected anatomical structures is only useful in selected cases such as,for example,the obstruction of selected vessels,a huge Thebesian valve,etc.The 3D images can add significant value;however,their usefulness is limited due to the different points of view that are obtained during intra-operational fluoroscopy.After summarizing all of the articles andguidelines,it can be recommended that the visualization of the coronary venous system be performed in certain patients before cardiac resynchronization.The best option is to use tomography with retrospective gating with the optimal reconstruction of cardiac veins that occurs during the diastolic phases.
文摘We are reporting a case of a 80-year-old lady with effort angina who underwent coronary angiography through the right radial artery, using a dedicated radial multipurpose 5 French Optitorque Tiger catheter. The catheter was advanced into the left ventricle and a left ventriculogram was obtained, while the catheter appeared optimally placed at the centre of the ventricle and the pressure waveform was normal. A large posterior interventricular vein draining into the right atrium was opacified, presumably because the catheter's end hole inadvertently cannulated an endocardial opening of a small thebesian vein, with subsequent retrograde filling of the epicardial vein. Our case suggests that caution is needed when a dedicated radial catheter with both an end-hole and a side hole is used for a ventriculogram, as a normal left ventricular pressure waveform does not exclude malposition of the end-hole against the ventricular wall.
