心脏多层CT对冠状窦与二尖瓣环和冠状动脉左旋支解剖学关系的在体分析:在经皮冠状窦二尖瓣环成形术中的应用  

In Vivo Analysis of the Anatomical Relationship of Coronary Sinus to Mitral Annulus and Left Circumflex Coronary Artery Using Cardiac Multidetector Computed Tomography. Implications for Percutaneous Coronary Sinus Mitral Annuloplasty

作　　者：Choure A.J. Garcia M.J. Hesse B. S.R.Kapadia 刘少伟 

机构地区：[1]Department of Cardiovascular Medicine,Cleveland Clinic,Cleveland,OH,United States Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2007年第4期57-58,共2页

摘　　要：目的:本研究旨在用心脏CT确定二尖瓣环(MA)与冠状窦(CS)以及CS与冠状动脉左旋支(LCX)之间的在体解剖学关系。背景:目前。Objectives:We sought to determine the in vivo anatomical relationships between mitral annulus(MA) and coronary sinus(CS) as well as CS and left circumflex coronary artery using cardiac computed tomography. Background:Percutaneous treatment of mitral regurgitation(MR) by annuloplasty via CS is under development. Success of such treatment depends on the close anatomical proximity of the MA to the CS. The in vivo data regarding this anatomical relationship in humans are scant. We investigated this relationship using contrast multidetector computed tomography. Methods:We studied 25 normal individuals and 11 patients with severe MR(3 to 4+) due to mitral valve prolapse. Separation between MA and CS was measured in standard planes,in 4-chamber(4C),2-chamber(2C),and 3-chamber views. Distance from ostium of CS to the intersection with left circumflex(LCX),and anatomical relation of LCX and CS were determined using 3-dimensional mapping(Philips Brilliance,Philips Medical Systems,Amsterdam,the Netherlands). Results:There was significant variance of CS to MA separation at all planes. Separation of CS and MA was increased in lateral location(4C) and decreased in posterior location(2C) in the MR group with increase in MA size. Left circumflex artery crossed between CS and MA in 80%of patients. The LCX crossed CS at a variable distance from the ostium of CS(86.5±21 mm,range 37 to 123 mm). Conclusions:There is significant variability in the relation of CS to MA in humans. Coronary sinus to MA distance increases in patients with severe MR and annular dilation,mainly in the posterolateral location. The left circumflex crosses under the CS the majority of times,but with a significant variability in the location where it crosses the CS. These anatomical features should be taken into consideration while selecting percutaneous treatment strategies for mitral valve repair.

关 键 词：瓣环成形术 左旋支 二尖瓣环 冠状窦 解剖学特点 二尖瓣反流 二尖瓣脱垂 标测 后位 发展阶段 

分 类 号：R816.2[医药卫生—放射医学]