Clinical cardiac structural anatomy reconstructed within the cardiac contour using multidetector-row computed tomography: Atrial septum and ventricular septum.

Cardiologists are increasingly becoming involved in procedures associated with the atrial septum and ventricular septum, such as transseptal puncture and selective site pacing. Moreover, detailed knowledge about the architecture of the atrial septum and ventricular septum is now available from studies by radiologists and anatomists. However, from the viewpoint of clinical cardiologists, many questions about the three-dimensional cardiac structural anatomy that relate closely to routine invasive procedures remain unresolved. Although modern multidetector-row computed tomography could provide answers, interventional cardiologists might have not considered the potential of this equipment, as only a few have performed studies with both radiological imaging and cadaveric hearts. Detailed knowledge of the three-dimensional fluoroscopic cardiac structural anatomy could help to reduce the need for contrast medium injection and radiation exposure, and to perform safe interventions. In this article, we present a series of cardiac structural images, including images of the atrial septum and ventricular septum, reconstructed in combination with the cardiac contour using multidetector-row computed tomography. We also discuss the clinical implications of the findings on the basis of accumulated insights of research pioneers. We hope that the present images will serve as a bridge between the fields of cardiology, radiology, and anatomy, and encourage cardiologists to integrate their accumulated insights into the three-dimensional clinical images of the living heart.