Pre-Operative Imaging of Coronary Veins in Patients Undergoing CRT: How Good Is Whole Heart MRA Compared to Intraoperative Catheter-Based Venography?

Adrian Lam¹, Luis F. Mora-Vieira², Michael Lloyd², John N. Oshinski, ¹²

The LV lead implantation location for Cardiac Resynchronization Therapy is determined by imaging the coronary venous anatomy with catheter-based retrograde venography during the implantation procedure, preventing pre-procedural planning. Current studies have shown that a modified whole heart MRA which combines a centric-ordering k-space scheme and a slow infusion of gadolinium is capable of imaging the coronary venous anatomy. In this work, we show that this MR sequence is capable of visualizing over 90% of the coronary venous anatomy when compared to the veins visible by retrograde venography.