The relationship between the coronary sinus and coronary artery using multislice spiral computed tomography and conventional invasive angiography.

BACKGROUND

Multislice computed tomography (MSCT) has been used extensively for coronary artery imaging. To understand the relationship between coronary artery and coronary sinus (CS) anatomy in patients undergoing electrophysiological study, conventional invasive angiography is typically performed. The purpose of this study was to image the coronary artery and CS and its tributaries using MSCT, in comparison with invasive angiography.

METHODS AND RESULTS

The study consisted of 141 patients (83 men, 58 women; age 52+/-10 years) who underwent 64-slice MSCT and 3D reconstruction and invasive coronary artery and CS angiography before radiofrequency catheter ablation. The cardiac venous system and coronary artery were visualized in all patients by MSCT and invasive angiography. All data of angiography and MSCT were measured via the same projection (right or left anterior oblique). Angiography and MSCT result revealed coronary arteries of all patients with a vessel diameter over 1 mm. The CS and the middle cardiac vein (MCV) were observed in all patients. MSCT provided high accuracy for the MCV to the CS ostium (CSO), the posterior interventricular vein (PIV) to CSO, and the mean diameter of MCV, PIV and CS ostia, compared with invasive angiography (p<0.001).

CONCLUSIONS

MSCT was a reliable tool to visualize the relationship between the coronary artery and CS and its tributaries. MSCT may improve the procedural success rate and reduce the complication rate in patients undergoing electrophysiological study.