Ablating Left-sided Atrioventricular Accessory Pathways in Young Patients with Persistent Left Superior Vena Cava: Start in the Coronary Sinus.
Year: 2025
Type: article
Study design: Case Report
Abstract: While hemodynamically insignificant, a persistent left superior vena cava (PLSVC) draining to the coronary sinus (CS) may have important implications during an electrophysiology study and catheter ablation. Specifically, ablation of left-sided accessory pathways (APs) poses a special challenge secondary to the potential distortion of the mitral valve annulus (MVA) and the possibility of the AP comprising a discrete epicardial trunk involving CS musculature. Ablation of such pathways is more likely accomplished from within the CS rather than on the MVA after a transseptal puncture. We describe two pediatric cases with a PLSVC draining to a dilated CS in whom successful ablation of left-sided APs was accomplished from within the CS after failed ablation attempts on the MVA. Initial mapping and ablation in the CS after a careful evaluation of the coronary artery proximity may obviate the need for a transseptal puncture with its potential challenges.
Source: PubMed
Authors: Soham Dasgupta, Christopher Johnsrude
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7119498327
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