Understanding Cardiac Anatomy and Imaging to Improve Safety of Procedures: The Right Ventricle

Takanori Sato; Kyle Adlaka; Issam D Moussa; Peter Hanna; Duc H Do; Michael C Fishbein; Kalyanam Shivkumar; Shumpei Mori

doi:10.1016/j.jcmg.2023.06.026

Understanding Cardiac Anatomy and Imaging to Improve Safety of Procedures: The Right Ventricle

JACC Cardiovasc Imaging. 2023 Oct;16(10):1348-1352. doi: 10.1016/j.jcmg.2023.06.026. Epub 2023 Aug 30.

Authors

Takanori Sato¹, Kyle Adlaka², Issam D Moussa³, Peter Hanna¹, Duc H Do¹, Michael C Fishbein⁴, Kalyanam Shivkumar¹, Shumpei Mori⁵

Affiliations

¹ Cardiac Arrhythmia Center, University of California-Los Angeles, Los Angeles, California, USA; Cardiovascular & Interventional Programs, University of California-Los Angeles Health System, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA.
² Cardiac Arrhythmia Center, University of California-Los Angeles, Los Angeles, California, USA; Cardiovascular & Interventional Programs, University of California-Los Angeles Health System, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA; Postbaccalaureate Premedical Program, University of Southern California, Los Angeles, California, USA.
³ Carle Illinois College of Medicine, University of Illinois, Carle Heart and Vascular Institute, Champaign, Illinois, USA.
⁴ Department of Pathology and Laboratory Medicine, University of California-Los Angeles, Los Angeles, California USA.
⁵ Cardiac Arrhythmia Center, University of California-Los Angeles, Los Angeles, California, USA; Cardiovascular & Interventional Programs, University of California-Los Angeles Health System, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA. Electronic address: [email protected].

PMID: 37656118
DOI: 10.1016/j.jcmg.2023.06.026

Abstract

Right ventricular perforation is a catastrophic complication of catheter-based intracardiac interventions. In this context, appreciation of 5 attachments of the right ventricle to the aortoventricular unit is essential to recognize extent of right ventricular free wall. We herein present progressive dissection and virtual and photographic endoscopic images of the hearts without distortion. Real dissection images show us how and where to avoid this complication by indicating the true muscular component of the ventricular septum. Both virtual and photographic endoscopic images, when combined with transillumination, beautifully shows the thin wall regions and trabeculations with unprecedented clarity. We believe recognition of these anatomical nuances can reduce the likelihood of right ventricular perforation.

Keywords: anatomy; cardiac perforation; endoscopic image; thin wall.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Diagnostic Imaging
Heart Injuries*
Heart Ventricles / diagnostic imaging
Heart Ventricles / surgery
Humans
Predictive Value of Tests
Ventricular Septum*

Grants and funding

OT2 OD023848/OD/NIH HHS/United States