Magnetic Resonance Cardiac Vein ImagingRelation to Mitral Valve Annulus and Left Circumflex Coronary Artery
Amedeo Chiribiri, MD*, ,
Sebastian Kelle, MD ,
Uwe Köhler, PhD,
Laurens F. Tops, MD ,
Bernhard Schnackenburg, PhD||,
Rodolfo Bonamini, MD,
Jeroen J. Bax, MD,
Eckart Fleck, MD,
Eike Nagel, MD, PhD*,*
* King's College London BHF Centre of Research Excellence, Division of Imaging Sciences, St. Thomas's Hospital, King's College London, London, United Kingdom
Department of Internal Medicine, University of Torino, Torino, Italy
Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
|| Philips Medical Systems, Hamburg, Germany
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Figure 1 Multiplanar-Reformatted Views Representing the Constant Separation Between the MVA Plane and the CS–GCV
The 2-chamber (A) and 4-chamber (B) views show the measurements of the distance between the coronary sinus–great cardiac vein (CS–GCV) and the mitral valve annulus (MVA) plane (green line). The red line represents a parallel line drawn through the center of the CS–GCV. LA = left atrium; LCX = left circumflex coronary artery; LM = left main coronary artery; LV = left ventricle; RA = right atrium; RV = right ventricle.
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Figure 2 Transparent Reconstruction of the Heart Fused With the CS–GCV, the LCX, and the MVA
The CS–GCV is represented in blue, the MVA in green, and the LCX in red. The CS–GCV and the LCX show a long parallel course. The MVA shows the typical saddle shape. Abbreviations as in Figure 1. See Online Video 1.
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Figure 3 Three-Dimensional Representation and Measurements of the Anatomical Relationship Between the CS–GCV, the MVA, and the LCX Along Their Entire Course
(A) Three-dimensional reconstruction showing a case with a long parallel course of the CS–GCV and the LCX. (B) Distance between the CS–GCV and the closest point of the LCX (purple line); distance between every point of the CS–GCV and the closest point of the MVA (yellow line). (C) Curved multiplanar reformatting showing the LCX running parallel to the CS–GCV in the same participant. (D) Three-dimensional reconstruction showing a case with a discrete crossing of the LCX under the CS–GCV. (E) Distance between the CS–GCV and the LCX (purple line); the distance of the CS–GCV from the MVA remains quite constant (yellow line). (F) Curved multiplanar reformatting showing the LCX crossing down the CS–GCV in the same participant. Ao = ascending aorta; LAD = left anterior descending coronary artery; MV = mitral valve; other abbreviations as in Figure 1.
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Figure 4 Three-Dimensional Reconstructions Showing the Anatomical Variability of the Relationships Between the Vascular Structures in the Atrioventricular Groove, and the Close Relationship Between the CS–GCV and the Left Atrial Wall
(A) Three-dimensional reconstruction (anterior view) showing the position of the CS–GCV and of the LCX, which makes a U-turn around the CS–GCV (U). (B) Three-dimensional reconstruction (posterior view) showing the position of the CS–GCV, which is adjacent to the left atrial wall rather than the MVA. The coronary arteries have been removed for better visualization of the atrioventricular groove. PIV = posterior interventricular vein; other abbreviations as in Figures 1 and 3.
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