Technical considerations for CRT-D implantation in different varieties of persistent left superior vena cava

Bontempi, Luca; Aboelhassan, Mohamed; Cerini, Manuel; Salghetti, Francesca; Fabbricatore, Davide; Maiolo, Vincenzo; Ghizzoni, Giulia; Curnis, Antonio

doi:10.1007/s10840-020-00843-6

Cited by 8 publications

(9 citation statements)

References 18 publications

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“…5,6 Lead implantation through PLSVC has been described as safe, although the procedure could be challenging. 8 Long dwell lead times are associated with the development of dense fibrotic adhesions that tend to calcify over time, affecting the ease of TLE. In an intracardiac-echocardiography-guided study, fibrotic adhesions were observed in the subclavian vein (80%), the innominate vein (68%), the right ventricle (68%) and the SVC (56%).…”

Section: Discussionmentioning

confidence: 99%

Transvenous lead extraction in patients with persistent left superior vena cava

Curnis

Aboelhassan

Cerini

et al. 2021

Cardiovasc electrophysiol

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Predictors of difficulty and complications of transvenous lead extraction (TLE) have been investigated in several studies; however, little is known about the venous anatomical characteristics that can have an impact on procedural outcomes. Among them, the persistent left superior vena cava (PLSVC) is a common anomaly often discovered incidentally during cardiac device implantation and could raise concerns if TLE is indicated.We report technical considerations and outcomes of TLE for two patients with leads implanted via PLSVC.Methods and Results: Two cardiac implantable electronic device recipients with isolated PLSVC required TLE due to infective endocarditis in one case and lead failure in the other. In the first case, TLE procedure was performed in a hybrid operating room with minimally invasive video-assisted thoracoscopic monitoring due to the high procedural risk. Two active fixation 20-year-old pacing leads were removed with a relatively short fluoroscopy time. In the second case, we successfully extracted a single-coil active fixation lead without the need of a locking stylet or advanced extraction tools. There were no procedural complications or adverse events at 1-year follow-up. Conclusion:TLE procedures for two patients with isolated PLSVC were successfully completed with less difficulty and tools than expected based on the characteristics of the targeted leads. If indicated, TLE in the presence of a PLSVC should be considered in experienced centers.

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Section: Discussionmentioning

confidence: 99%

Transvenous lead extraction in patients with persistent left superior vena cava

Curnis

Aboelhassan

Cerini

et al. 2021

Cardiovasc electrophysiol

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“…Such venous system implies a perspective change for the electrophysiologist: achieving optimal pacing sites becomes more complex, making the whole procedure more challenging. A few case reports have already described how to face this challenging anatomy 3–5 . The present case specifically addresses the implantation technique providing tricks and suggestions to make the procedure safe and feasible.…”

Section: Figurementioning

confidence: 99%

“…A few case reports have already described how to face this challenging anatomy. 3 , 4 , 5 The present case specifically addresses the implantation technique providing tricks and suggestions to make the procedure safe and feasible.…”

mentioning

confidence: 99%

Active fixation of bipolar left ventricular lead through a persistent left superior vena cava

Nicolis

Mugnai

Pepi

et al. 2022

Journal of Arrhythmia

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“…4 Consequently, approaches to navigate narrow, tortuous, and complex anatomy have been described. [5][6][7][8] We describe a case in which retrograde snaring was employed to successfully deliver the LV lead through a PLSVC for CRT implantation.…”

Section: Introductionmentioning

confidence: 99%