Spatial relationship between the pulmonary trunk and the left coronaries: Systematic risk assessment based on automated three-dimensional distance measurements.

Heart Rhythm O2
Eberhard ScholzSebastian Sager

Abstract

Catheter ablation of right ventricular outflow tract ventricular arrhythmias from above the pulmonary valve is being increasingly reported. The purpose of this study was to systematically analyze the spatial relationship between the pulmonary trunk and the left coronaries. Contrast-enhanced computed tomographic scans from 58 patients were analyzed. After segmentation of the pulmonary trunk and the proximal left coronaries, 3-dimensional geometries were generated. Minimal distance between the pulmonary trunk and the coronaries was automatically determined using a newly developed mathematical algorithm. The minimal distance between the pulmonary trunk and the coronaries was 1.4 ± 0.11 mm. Closest relationship was detected 13.8 ± 0.87 mm above the pulmonary valve annulus. Considering a safety margin of 5 mm to render coronary damage unlikely, 84% of patients were found to be at potential risk within the bottom 10 mm of the left sinus cusp. In contrast, positions within or above the right and anterior cusps were less likely to exhibit a close relationship. We identified the anterior aspect of the left cusp as the most critical region. Positions 10-20 mm above the left cusp were found to be critical in 97% of patients. Clinical para...Continue Reading

References

Mar 5, 2003·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Roland G DemariaLouis P Perrault
Jul 14, 2006·Journal of Cardiovascular Electrophysiology·Marmar VaseghiKalyanam Shivkumar
Aug 12, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Katie A Walsh, Gerard J Fahy
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May 4, 2017·Journal of Cardiovascular Electrophysiology·Yufan YangShenghua Zhou
May 5, 2017·Journal of Cardiovascular Electrophysiology·Christian-Hendrik HeegerFeifan Ouyang
Aug 13, 2017·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jinlin ZhangXi Su

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Citations

Jun 25, 2021·Journal of Cardiovascular Electrophysiology·Maciej LisMateusz K Hołda

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Software Mentioned

learn
EP planning
IntelliSpace
numpy
Meshmixer
scikit
Python

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