Long-term follow-up after pacemaker implantation via persistent left superior vena cava

Dąbrowski, Paweł; Obszański, Bogdan; Kleinrok, Andrzej; Kutarski, Andrzej

doi:10.5603/cj.a2013.0145

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…The literature is quite poor in cases of implantation of the transvenous pacing electrodes through a persistent left superior vena cava. What is really difficult is the positioning of the right ventricular electrode because of the sharp angles which the lead has to travel to the final position, either at the apical level or at the level of the interventricular septum [7][8][9][10][11][12][13]. Theoretically, those sharp angles of the ventricular lead seem to have an increased risk of lead fracture but we did not find any reported case of right ventricular lead fracture placed through a PLSVC.…”

Section: Introductionmentioning

confidence: 72%

Permanent pacemaker implantation in a challenging anatomy: Persistent left superior vena cava

Bostan¹,

Astratinei²,

Tăbăcaru³

et al. 2020

Arch Clin Cases

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The persistence of the left superior vena cava is one of the most common abnormalities that could affect the thoracic venous return, despite its rare occurrence. It can usually be found as the only or in combination with other congenital cardiac abnormalities. Even though it is usually asymptomatic and it rarely has important consequences on the hemodynamics, it could sometimes represent a serious threat. In this regard, PLSVC often represents an incidental finding during an invasive procedure or imaging. We present an interesting case of a 66-year-old patient, with permanent atrial fibrillation and chronic kidney disease who presented to our clinic for a syncope due to complete atrioventricular block. The implant procedure was marked by the incidental intraprocedural finding of unusual venous anatomy. This anomaly included the absence of the superior vena cava, with the communication of the right brachiocephalic trunk and right subclavian vein with a persistent left superior vena cava which drainage directly into the coronary sinus. The right-side approach, as well as the limitation of using contrast-based venography, due to the kidney disease, made the procedure more difficult, but the final position of an active fixation ventricular lead was successfully achieved with optimal and stable pacing parameters through the formation of a particular curve of the lead stylet. Persistence of the left superior vena cava is a venous anomaly, which is frequently suspicioned at transthoracic echocardiography examination when the examiner found a dilated coronary sinus but diagnosed on the implant table of a cardiac device. These anomalies can pose problems and exponentially increase the procedural time even in experienced hands.

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Section: Introductionmentioning

confidence: 72%

Permanent pacemaker implantation in a challenging anatomy: Persistent left superior vena cava

Bostan¹,

Astratinei²,

Tăbăcaru³

et al. 2020

Arch Clin Cases

View full text Add to dashboard Cite

show abstract

“…From the technical point of view, since there is an acute angle between the coronary sinus ostium and the tricuspid valve, the lead should be looped in the right atrium and then advanced into the right ventricle. Active fixation leads and hand-shaped stylets are recommended in order to overcome technical difficulties [ 23 , 24 , 25 , 26 ]. Many cases of single chamber pacemaker implantation via a PLSVC have been reported over the years, but also there have been published cases where dual chamber pacemaker and defibrillator implantation was achieved via PLSVC, and a few reports of successful cardiac resynchronization therapy [ 27 , 28 , 29 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Pacemaker Implantation in a Patient with Isolated Persistent Left Superior Vena Cava Draining into the Left Atrium: A Case Report and Brief Literature Review

et al. 2022

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Anomalies of the thoracic venous system are rare and usually discovered incidentally, but they become clinically relevant in the case of patients requiring cardiac device implantation. Persistent left superior vena cava is considered the most common venous drainage abnormality, with several anatomical variants that generate technical difficulties during pacemaker or defibrillator lead placement. We report a case of an isolated persistent left superior vena cava with abnormal drainage into the left atrium, associated with a hypoplastic right-sided superior vena cava, in a patient scheduled for permanent pacemaker implantation. Considering the patient’s anatomical characteristics, a transvenous approach proved unfeasible and the procedure was successfully accomplished via the surgical placement of a left ventricle epicardial lead. We aim to emphasize the clinical importance of such venous anomalies and to discuss the practical implications and challenges derived from these types of conditions, especially in the field of electrophysiology.

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Vein Management for Cardiac Device Implantation

Al-Hadithi

Boyle

2018

Cardiac Electrophysiology Clinics

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Long-term follow-up after pacemaker implantation via persistent left superior vena cava

Abstract: (Cardiol J 2014; 21, 4: 413-418)

Cited by 5 publications

References 14 publications

Permanent pacemaker implantation in a challenging anatomy: Persistent left superior vena cava

Permanent pacemaker implantation in a challenging anatomy: Persistent left superior vena cava

Pacemaker Implantation in a Patient with Isolated Persistent Left Superior Vena Cava Draining into the Left Atrium: A Case Report and Brief Literature Review

Vein Management for Cardiac Device Implantation

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