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Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review
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 cardi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763180/ https://www.ncbi.nlm.nih.gov/pubmed/33322042 http://dx.doi.org/10.3390/diagnostics10121071 |
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author | Haba, Mihai Cristian Ursaru, Andreea Maria Petriș, Antoniu Octavian Popescu, Ștefan Eduard Tesloianu, Nicolae Dan |
author_facet | Haba, Mihai Cristian Ursaru, Andreea Maria Petriș, Antoniu Octavian Popescu, Ștefan Eduard Tesloianu, Nicolae Dan |
author_sort | Haba, Mihai Cristian |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7763180 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-77631802020-12-27 Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review Haba, Mihai Cristian Ursaru, Andreea Maria Petriș, Antoniu Octavian Popescu, Ștefan Eduard Tesloianu, Nicolae Dan Diagnostics (Basel) Case Report 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. MDPI 2020-12-10 /pmc/articles/PMC7763180/ /pubmed/33322042 http://dx.doi.org/10.3390/diagnostics10121071 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Haba, Mihai Cristian Ursaru, Andreea Maria Petriș, Antoniu Octavian Popescu, Ștefan Eduard Tesloianu, Nicolae Dan Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review |
title | Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review |
title_full | Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review |
title_fullStr | Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review |
title_full_unstemmed | Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review |
title_short | Implantation of a Dual-Chamber Automatic Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava: Case Report and Brief Literature Review |
title_sort | implantation of a dual-chamber automatic cardioverter defibrillator in a patient with persistent left superior vena cava: case report and brief literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763180/ https://www.ncbi.nlm.nih.gov/pubmed/33322042 http://dx.doi.org/10.3390/diagnostics10121071 |
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