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Characterization of a New Pulmonary Vein Variant Using Magnetic Resonance Angiography:
Author(s) -
LICKFETT LARS,
KATO RITSUSHI,
TANDRI HARIKRISHNA,
JAYAM VINOD,
VASAMREDDY CHANDRASEKHAR R.,
DICKFELD TIMM,
LEWALTER THORSTEN,
LUDERITZ BERNDT,
BERGER RONALD,
HALPERIN HENRY,
CALKINS HUGH
Publication year - 2004
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2004.03499.x
Subject(s) - medicine , coronal plane , magnetic resonance imaging , ostium , pulmonary vein , stenosis , magnetic resonance angiography , catheter ablation , nuclear medicine , atrial fibrillation , radiology , cardiology
Catheter ablation of the pulmonary veins (PVs) for prevention of recurrent atrial fibrillation requires precise anatomic information. We describe the characteristics of a new anatomic variant of PV anatomy using magnetic resonance angiography. Methods and Results: A 1.5‐T magnetic resonance imaging system with a body coil or a torso phased‐array coil was used before and after gadolinium injection. Magnetic resonance angiograms were acquired with a breath‐hold three‐dimensional fast spoiled gradient‐echo imaging sequence in the coronal plane. Three‐dimensional reconstruction with maximum intensity projections and multiplanar reformations was performed. A newly described variant PV ascending from the roof of the left atrium was found in 3 of 91 subjects. The mean ostial diameter of the roof PV was 7 ± 2 mm, the mean distance from the ostium to the first branching point was 22 ± 8.5 mm, and the mean distance to the right superior PV was 3.3 ± 0.6 mm. Conclusion: We refer to the newly described variant of PV anatomy as the “right top pulmonary vein.” It is important to be aware of this anatomic pattern to avoid inadvertent catheter intubation, which can result in misleading mapping results and PV stenosis. (J Cardiovasc Electrophysiol, Vol. 15, pp. 538‐543, May 2004)