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Cardiac resynchronization therapy in a patient with persistent left superior vena cava draining into the coronary sinus and absent innominate vein: a case report and review of literature.

Nair GM, Shen S, Nery PB, Redpath CJ, Birnie DH - Indian Pacing Electrophysiol J (2014)

Bottom Line: Persistent left superior vena cava (PLSVC) is a rare congenital anomaly of the superior venous system that may be discovered at the time of cardiac implantable electronic device (CIED) implantation.Superior venous anomalies such as PLSVC can make CIED implantation technically challenging.However, with increasing operator experience, cardiac imaging and appropriate tools successful CIED implantation is possible in almost all cases.

View Article: PubMed Central - PubMed

Affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.

ABSTRACT

Introduction: Persistent left superior vena cava (PLSVC) is a rare congenital anomaly of the superior venous system that may be discovered at the time of cardiac implantable electronic device (CIED) implantation.

Methods and results: We present a subject who needed cardiac resynchronization therapy (CRT)-CIED implantation and was discovered to have PLSVC with absent innominate vein during the implant procedure. We were able to successfully implant a CRT-CIED using a right-sided approach via the right superior vena cava (SVC). We present a description of our implant technique and a brief review of the different aspects of CIED implantation in subjects with variants of PLSVC.

Conclusion: Superior venous anomalies such as PLSVC can make CIED implantation technically challenging. However, with increasing operator experience, cardiac imaging and appropriate tools successful CIED implantation is possible in almost all cases.

No MeSH data available.


Related in: MedlinePlus

Final position of pacing leads in the heart. RA- Right atrium; RV- Right Ventricle; CS- Coronary sinus
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Figure 4: Final position of pacing leads in the heart. RA- Right atrium; RV- Right Ventricle; CS- Coronary sinus

Mentions: We were able to successfully implant a CRT-CIED system using a right-sided approach. A straight coronary sinus cannulation catheter (Medtronic 7F catheterTM) was introduced over a deflectable decapolar electrophysiological diagnostic catheter into the CS, distal to its confluence with the PLSVC. A venogram demonstrated the presence of a lateral CS tributary of adequate caliber for CS pacing lead placement. An endocardial bipolar pace-sense CS lead (Medtronic 6F 4194 leadTM) was introduced over a 0.014" coronary guide wire (WHISPER extra-support; Abbott VascularTM) into this tributary (Figure 3 and 4). The subject withstood the procedure well without any acute complications and was discharged home.


Cardiac resynchronization therapy in a patient with persistent left superior vena cava draining into the coronary sinus and absent innominate vein: a case report and review of literature.

Nair GM, Shen S, Nery PB, Redpath CJ, Birnie DH - Indian Pacing Electrophysiol J (2014)

Final position of pacing leads in the heart. RA- Right atrium; RV- Right Ventricle; CS- Coronary sinus
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4217305&req=5

Figure 4: Final position of pacing leads in the heart. RA- Right atrium; RV- Right Ventricle; CS- Coronary sinus
Mentions: We were able to successfully implant a CRT-CIED system using a right-sided approach. A straight coronary sinus cannulation catheter (Medtronic 7F catheterTM) was introduced over a deflectable decapolar electrophysiological diagnostic catheter into the CS, distal to its confluence with the PLSVC. A venogram demonstrated the presence of a lateral CS tributary of adequate caliber for CS pacing lead placement. An endocardial bipolar pace-sense CS lead (Medtronic 6F 4194 leadTM) was introduced over a 0.014" coronary guide wire (WHISPER extra-support; Abbott VascularTM) into this tributary (Figure 3 and 4). The subject withstood the procedure well without any acute complications and was discharged home.

Bottom Line: Persistent left superior vena cava (PLSVC) is a rare congenital anomaly of the superior venous system that may be discovered at the time of cardiac implantable electronic device (CIED) implantation.Superior venous anomalies such as PLSVC can make CIED implantation technically challenging.However, with increasing operator experience, cardiac imaging and appropriate tools successful CIED implantation is possible in almost all cases.

View Article: PubMed Central - PubMed

Affiliation: Arrhythmia Service, Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Ave, Ottawa, Canada - K1Y 4W7.

ABSTRACT

Introduction: Persistent left superior vena cava (PLSVC) is a rare congenital anomaly of the superior venous system that may be discovered at the time of cardiac implantable electronic device (CIED) implantation.

Methods and results: We present a subject who needed cardiac resynchronization therapy (CRT)-CIED implantation and was discovered to have PLSVC with absent innominate vein during the implant procedure. We were able to successfully implant a CRT-CIED using a right-sided approach via the right superior vena cava (SVC). We present a description of our implant technique and a brief review of the different aspects of CIED implantation in subjects with variants of PLSVC.

Conclusion: Superior venous anomalies such as PLSVC can make CIED implantation technically challenging. However, with increasing operator experience, cardiac imaging and appropriate tools successful CIED implantation is possible in almost all cases.

No MeSH data available.


Related in: MedlinePlus