Pacemaker implantation using the SelectSecure system for a patient with persistent left superior vena cava and absent right superior vena cava: Insights into techniques for stable lead fixation

Abstract

The techniques for successful pacemaker implantation via the PLSVC with the SelectSecure system (Medtronic, Minneapolis, Minnesota, USA) are unknown. Regarding the techniques, we presented a case in which we implanted a pacemaker via the PLSVC in patient with absent RSVC using the SelectSecure system.

Left ventricular lead delivery system used to implant right ventricular lead via persistent left superior vena cava

“…To our knowledge, it is the first time that this technique has been used in the placement of PM lead via PLSVC in literature. Some other techniques were used for implantation of PM in different cases who had PLSVC like anchor balloon, C type stylet or catheter delivery system 3–5 …”

“…[3][4][5] The abnormal anatomy of PLSVC may cause difficulties in lead fixation due to an angle between the orifice of the CS and the tricuspid valve. [3][4][5] According to this technique, it is easy to pass from PLSVC to RV via tricuspid valve with wire and deliver ventricular PM lead to RV CS sheath in tortuous and calcific vessel with or without PLSVC. In our case passing from tortuous PLSVC with CS sheath has been conducted safely and rapidly without any complications.…”

“…Thus, it should be emphasized that the techniques for PM implantation through the PLSVC are quite rare. 3 , 4 , 5 …”

“…Some other techniques were used for implantation of PM in different cases who had PLSVC like anchor balloon, C type stylet or catheter delivery system. 3 , 4 , 5 …”

Double Superior Vena Cava Due to Persistent Left Superior Vena Cava Incidentally Identified on Central Venous Catheterization: A Case Report

“…In some cases, the right-sided SVC is absent, and in other cases the left brachiocephalic vein is absent [ 7 – 9 ]. Anatomical SVC variation is typically asymptomatic but may complicate clinical intravascular procedures such as central line placement [ 10 ], hemodialysis catheterization [ 11 ], Swan-Ganz catheterization [ 12 ], and pacemaker implantation [ 13 , 14 ]. This report presents the case of a 40-year-old man with an incidental finding of double SVC due to PLSVC identified on hospital admission following a motor vehicle collision.…”