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首页> 外文期刊>Journal of cardiovascular medicine >Anatomic relationship between left coronary artery and left atrium in patients undergoing atrial fibrillation ablation
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Anatomic relationship between left coronary artery and left atrium in patients undergoing atrial fibrillation ablation

机译：左冠状动脉与左心房对患者进行心房颤动消融患者的解剖关系

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BackgroundAtrial fibrillation transcatheter ablation (TCA) is, within available atrial fibrillation rhythm control strategies, one of the most effective. To potentially improve ablation outcome in case of recurrent atrial fibrillation after a first procedure or in presence of structural myocardial disease, isolation of the pulmonary veins may be associated with extensive lesions within the left atrium. To avoid rare, but potentially life-threatening, complications, thorough knowledge and assessment of left atrium anatomy and its relation to structures in close proximity are, therefore, mandatory. Aim of the present study is to describe, by cardiac computed tomography, the anatomic relationship between aortic root, left coronary artery and left atrium in patients undergoing atrial fibrillation TCA.Methods and resultsThe cardiac computed tomography scan of 21 patients affected by atrial fibrillation was elaborated to segment left atrium, aortic root and left coronary artery from the surrounding structures and the following distances measured: left atrium and aortic root; left atrium roof and aortic root; left main coronary artery and left atrium; circumflex artery and left atrium appendage; and circumflex artery and mitral valve annulus. Above all, the median distance between left atrium and aortic root (1.9, 1.5-2.1mm), and between circumflex artery and left atrium appendage ostium (3.0, 2.1-3.4mm) were minimal (3mm). None of measured distances significantly varied between patients presenting paroxysmal versus persistent atrial fibrillation.ConclusionThe anatomic relationship between left atrium and coronary arteries is extremely relevant when performing atrial fibrillation TCA by extensive lesions. Therefore, at least in the latter case, preablation imaging should be recommended to avoid rare, but potentially life-threatening, complications with the aim of an as well tolerated as possible procedure.
机译：背景心房颤动经导管消融（TCA）在现有的心房颤动节律控制策略中是最有效的方法之一。为了提高首次手术后复发性心房颤动或存在结构性心肌疾病时的消融效果，肺静脉隔离可能与左心房内的广泛病变有关。因此，为了避免罕见但可能危及生命的并发症，必须全面了解和评估左心房解剖及其与邻近结构的关系。本研究的目的是通过心脏计算机断层扫描，描述接受心房颤动TCA患者主动脉根部、左冠状动脉和左心房之间的解剖关系。方法和结果对21例心房颤动患者的心脏CT扫描进行了详细阐述，将左心房、主动脉根部和左冠状动脉与周围结构分开，并测量以下距离：左心房和主动脉根部；左心房顶和主动脉根部；左冠状动脉主干和左心房；回旋动脉和左心耳；回旋动脉和二尖瓣环。最重要的是，左心房和主动脉根部之间（1.9,1.5-2.1mm）以及回旋动脉和左心房附件开口之间（3.0,2.1-3.4mm）的中位距离最小（3mm）。在阵发性房颤和持续性房颤患者之间，测量的距离没有显著差异。结论在大面积病变的心房颤动TCA中，左心房和冠状动脉之间的解剖关系极为相关。因此，至少在后一种情况下，应建议进行清创前成像，以避免罕见但可能危及生命的并发症，目的是尽可能进行耐受性良好的手术。

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