Work

Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review

Year: 2020

Type: article

Abstract: Persistence of the left superior vena cava (PLSVC) is a congenital anomaly reported in 0.3-0.5% of patients. Due to the multiple and complex anatomical variations, transvenous lead placement can become challenging. We report the case of a 47-year-old patient diagnosed with non-ischemic dilated cardiomyopathy with reduced left ventricular ejection fraction (LVEF-27%), who was referred to our clinic for implantation of a dual-chamber cardioverter defibrillator for primary prevention of sudden cardiac death. During the procedure we encountered an abnormal guidewire trajectory and after venographic examination we established the diagnosis of persistent left superior vena cava. After difficult implantation of a 7F defibrillation lead through the coronary sinus, we managed to place the atrial lead through a narrow brachiocephalic vein into the right atrial appendage. In this paper, we aim to illustrate the medical and technical implications of implanting a cardioverter defibrillator in patients with PLSVC, highlighting the benefit of identifying and utilizing both the innominate vein, and the left superior vena cava and coronary sinus for placement of multiple leads, which would otherwise have been impossible.

Source: Diagnostics

DOI: 10.3390/diagnostics10121071

Authors: Mihai Cristian Haba, Andreea Maria Ursaru, Antoniu Octavian Petriș, Ștefan Eduard Popescu, Nicolae Dan Tesloianu

Institutions: Grigore T. Popa University of Medicine and Pharmacy, Spitalul Clinic Judeţean de Urgenţe "Sf. Spiridon" Iaşi

Language: English

Topic: Cardiac pacing and defibrillation studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,479