Resumo

DIAZ, Juan C. et al. Evaluación de las características morfológicas de la aurícula izquierda por tomografía computarizada multicorte: Determination of the anatomical characteristics of the left atrium by computed tomography. Rev. Colomb. Cardiol. [online]. 2015, vol.22, n.6, pp.285-293. ISSN 0120-5633.  https://doi.org/10.1016/j.rccar.2015.05.008.

Objective: Describe the anatomical characteristics of the left atrium and pulmonary veins in patients with paroxysmal or persistent atrial fibrillation using computed tomography images and the possible impact these might have on pulmonary vein ablation and percutaneous left atrial appendage occlusion. Methods: Evaluation of computed tomography images from adult patients with paroxysmal or persistent atrial fibrillation who were treated with pulmonary vein ablation from January 1^st, 2011 to June 30^th 2012. Patients with previous cardiac surgery, pulmonary vein ablation or permanent atrial fibrillation were excluded. Multiplanar reconstrucion was performed in all patients, with three dimensional and endoluminal reconstruction performed in select patients. Results: Forty six patients (37 male, 80.5%) with a mean age of 59.7 ± 11.1 years (range: 22-81 years) were included. Accessory veins were common, most of them on the right side with only one case of left sided accessory vein. A larger size of the venous ostia and a longer distance from the ostia to the first bifurcation than previously described was found. A total of 11 patients (24%) had a left atrial appendage ostium diameter larger than 28.5 mm and 9 patients (19.5%) had a diameter larger than 30 mm, which is the maximum limit for the use of left atrial appendage devices. Conclusions:Anatomical characteristics of the left atrium and pulmonary veins have variations in different populations which should be taken into account prior to pulmonary vein ablation and left atrial appendage occlusion.

Palavras-chave : Fibrillation; Left atrium; Tomography; Veins; Ablation.

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