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Article: Endocardial visualization of esophageal-left atrial anatomic relationship by three-dimensional multidetector computed tomography "navigator imaging"

TitleEndocardial visualization of esophageal-left atrial anatomic relationship by three-dimensional multidetector computed tomography "navigator imaging"
Authors
Issue Date2006
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1
Citation
Pace - Pacing And Clinical Electrophysiology, 2006, v. 29 n. 5, p. 502-508 How to Cite?
Abstract
Background: The close proximity of left atrium (LA) and esophagus during radiofrequency ablation for atrial fibrillation (AF) predisposes to thermal injury resulting in atrio-esophageal fistula. This work proposes to study the anatomic relationship between the esophagus and the LA wall using multidetector computed tomography (MDCT) three-dimensional (3D) "Navigator" reconstruction technique. Methods: Forty-five consecutive patients (37 men, mean age 52.7 ± 14.1 years) with preradiofrequency ablation MDCT scans of the thorax for AF were recruited. Length and type (continuous or interrupted) of fat pad between esophagus and LA were evaluated. The position, width, and length of the esophagus in contact (without fat pad) with the LA were determined by using "Navigator" software on the endocardial view of LA. Results: The fat pad was continuous in 4% (2 of 45) and interrupted in 96% (43 of 45) patients. The mean width and length of esophageal-LA contact in 43 cases with interrupted fat pad was 24.0 ± 5.8 mm (range 10.5-35.3 mm) and 41.9 ± 11.6 mm (5.4-64 mm), respectively. There was an inverse relationship between the lengths of the esophageal-LA contact and the upper fat pad (r = -0.50, P = 0.001). The esophagus was located to the left, right, and midline of the LA in 40, 2, and 1 patients, respectively, and the esophagus was in contact with and overrode the PV orifice in 22 and 4 patients, respectively. Conclusion: Direct esophageal-LA contact without the intervening fat pad was present in 96% of the cases, with 93% of esophagi lying to the left of the LA and 51% in contact with a PV orifice. Three-dimensional Navigator imaging technique has enhanced the visualization of the anatomical information of the esophagus, LA wall, and PV orifices that may be used to avoid thermal injury to the esophagus during LA ablation procedure. ©2006, Blackwell Publishing, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/162975
ISSN
2013 Impact Factor: 1.250
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, SLen_US
dc.contributor.authorOoi, CGCen_US
dc.contributor.authorSiu, CWen_US
dc.contributor.authorYiu, MWCen_US
dc.contributor.authorPang, Cen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorTse, HFen_US
dc.date.accessioned2012-09-05T05:26:05Z-
dc.date.available2012-09-05T05:26:05Z-
dc.date.issued2006en_US
dc.identifier.citationPace - Pacing And Clinical Electrophysiology, 2006, v. 29 n. 5, p. 502-508en_US
dc.identifier.issn0147-8389en_US
dc.identifier.urihttp://hdl.handle.net/10722/162975-
dc.description.abstractBackground: The close proximity of left atrium (LA) and esophagus during radiofrequency ablation for atrial fibrillation (AF) predisposes to thermal injury resulting in atrio-esophageal fistula. This work proposes to study the anatomic relationship between the esophagus and the LA wall using multidetector computed tomography (MDCT) three-dimensional (3D) "Navigator" reconstruction technique. Methods: Forty-five consecutive patients (37 men, mean age 52.7 ± 14.1 years) with preradiofrequency ablation MDCT scans of the thorax for AF were recruited. Length and type (continuous or interrupted) of fat pad between esophagus and LA were evaluated. The position, width, and length of the esophagus in contact (without fat pad) with the LA were determined by using "Navigator" software on the endocardial view of LA. Results: The fat pad was continuous in 4% (2 of 45) and interrupted in 96% (43 of 45) patients. The mean width and length of esophageal-LA contact in 43 cases with interrupted fat pad was 24.0 ± 5.8 mm (range 10.5-35.3 mm) and 41.9 ± 11.6 mm (5.4-64 mm), respectively. There was an inverse relationship between the lengths of the esophageal-LA contact and the upper fat pad (r = -0.50, P = 0.001). The esophagus was located to the left, right, and midline of the LA in 40, 2, and 1 patients, respectively, and the esophagus was in contact with and overrode the PV orifice in 22 and 4 patients, respectively. Conclusion: Direct esophageal-LA contact without the intervening fat pad was present in 96% of the cases, with 93% of esophagi lying to the left of the LA and 51% in contact with a PV orifice. Three-dimensional Navigator imaging technique has enhanced the visualization of the anatomical information of the esophagus, LA wall, and PV orifices that may be used to avoid thermal injury to the esophagus during LA ablation procedure. ©2006, Blackwell Publishing, Inc.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0147-8389&site=1en_US
dc.relation.ispartofPACE - Pacing and Clinical Electrophysiologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshEndocardium - Anatomy & Histology - Radiographyen_US
dc.subject.meshEsophagus - Anatomy & Histology - Radiographyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Atria - Anatomy & Histology - Radiographyen_US
dc.subject.meshHumansen_US
dc.subject.meshImaging, Three-Dimensional - Methodsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshSurgery, Computer-Assisted - Methodsen_US
dc.subject.meshTomography, X-Ray Computed - Instrumentation - Methodsen_US
dc.subject.meshTransducersen_US
dc.subject.meshUser-Computer Interfaceen_US
dc.titleEndocardial visualization of esophageal-left atrial anatomic relationship by three-dimensional multidetector computed tomography "navigator imaging"en_US
dc.typeArticleen_US
dc.identifier.emailSiu, CW:cwdsiu@hkucc.hku.hken_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authoritySiu, CW=rp00534en_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1540-8159.2006.00384.xen_US
dc.identifier.pmid16689846en_US
dc.identifier.scopuseid_2-s2.0-33646516580en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33646516580&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume29en_US
dc.identifier.issue5en_US
dc.identifier.spage502en_US
dc.identifier.epage508en_US
dc.identifier.isiWOS:000237353200014-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWang, SL=24598284300en_US
dc.identifier.scopusauthoridOoi, CGC=7007084909en_US
dc.identifier.scopusauthoridSiu, CW=7006550690en_US
dc.identifier.scopusauthoridYiu, MWC=6701813671en_US
dc.identifier.scopusauthoridPang, C=13408410100en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.citeulike616652-

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