Cardiac resynchronization therapy device implantation in a patient with persistent left superior vena cava without communicating innominate vein - should we proceed from the same side? - A dilemma revisited.

Abstract

Persistent left superior vena cava (PLSVC) is an uncommon congenital anomaly. We report a case of implantation of cardiac resynchronization therapy - pacemaker (CRT-P) device in a 38-year-old lady with idiopathic dilated cardiomyopathy. After left axillary vein puncture, we faced an unexpected entry of left subclavian to PLSVC draining into the coronary sinus (CS). The target posterolateral vein which had been identified before, seemed to have an acute angle at its entry into the CS. Hence, at this stage we were in a dilemma, whether to switch to the right side or to continue from the same side. We continued the procedure from the left side and completed it successfully after some manipulation and improvisation.

• Authors: Debabrata Bera, Neeta Bachani, Prashant Pawar, Chetan Rathi, Vadivelu Ramalingam, Yash Lokhandwala
• Journal: Indian pacing and electrophysiology journal (Indian Pacing Electrophysiol J) 2018 May - Jun Vol. 18 Issue 3 Pg. 112-114 ISSN: 0972-6292 [Print] Netherlands
• PMID: 29274800 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. All rights reserved.