Prevalence and Characterization of Pulmonary Vein Variants in Patients with Atrial Fibrillation Determined using Multislice Computed Tomography

Abstract

In our current study ,we aimed to analyze the anatomical pattern of pulmonary veins in patients who have atrial fibrillation by Multislice computed tomography to visualize the pulmonary veins and left atrium non invasively by creating high quality 3- dimensional images in comparison to normal subjects who have no AF. Imaging of pulmonary veins and left atrium should include: i) The precise anatomy of left atrium and PVs. ii) The precise measurement of each osteal diameter of the pulmonary veins. iii) Presence of accessory PVs. iv) The left atrial dimension and the presence of LAA thrombus, and v) major anomalies like common PV ostia , persistent left superior vena cava, anomalous pulmonary venous return, or the hypoplasty or occlusion of PV. The patients were divided into two groups : - One hundred patients who have AF and another one hundred normal control subjects underwent Multislice CT angio on coronary arteries and PVs and left atrium at Maadi Military Hospital. Those patients were selected according to the fact that they met the inclusion criteria. AF group: Typical left atrial anatomy with four distinct PVs was found in 63 % of cases , but the remaining 37% showed anatomical variants of the PVs :( 31% had left common ostium, 4% had right common ostium and 2% had right middle PVs.) Control group: Typical left atrial anatomy with four distinct PVs was found in 84% of cases, but the remaining 16% showed anatomical variants of PVs: (15% had left common ostium , one patient had right common ostium and no patient in this group had right middle PV).