Response by Fender et al to Letter Regarding Article, “Severe Pulmonary Vein Stenosis Resulting From Ablation for Atrial Fibrillation: Presentation, Management, and Clinical Outcomes”
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We appreciate the thoughtful letter by Jazayeri et al. Assessment of the pulmonary veins (PVs) using cardiac computed tomography is challenging and requires a systematic approach to ensure accurate measurements are obtained. Some of the difficulties that must be addressed include defining the venous ostium and tracking the 3-dimensional course of the vein as it traverses multiple imaging planes. Our practice has been to use the venous carina to define the edge of the ostium, which becomes a reference point for a centerline extending from the ostium to the distal vein.1–3 We then use en-face and orthogonal slices extracted from the image volume to make cross-sectional measurements along the course of the vein. …