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Figure 8 Congenital Anomaly of the Coronary Venous System in a Patient Referred for CRT
This patient has a persistent left superior vena cava (LSVC) and a markedly enlarged coronary sinus and great cardiac vein (GCV). The upper panel shows a 3-dimensional volume-rendered reconstruction, illustrating the LSVC and coronary venous system. The lower panels show multiplanar reformatted images, where the target vein (posterolateral branch) for left ventricular lead implantation is identified (arrows). Left ventricular lead implantation for cardiac resynchronization therapy (CRT) is significantly more complicated in patients like these. A noninvasive pre-procedure evaluation with multidetector row computed tomography for elucidation of the "road map" can be very helpful.
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