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Coronary vein balloon angioplasty for left ventricular pacemaker lead implantation
Bert Hansky1, Barbara Lamp, Kazutomo Minami
1Department of Thoracic and Cardiovascular Surgery, Bad Oeynhausen, Germany. bhansky@hdz-nrw.de
Objectives:
Retrospective analysis of five cases of coronary vein balloon angioplasty performed to allow insertion of left ventricular pacing leads.
Background:
Coronary vein stenoses or an insufficient vessel caliber can preclude transvenous placement of coronary vein leads.
Methods:
We compared our total patient population (n = 218), in whom we implanted coronary vein leads, to those five patients who required coronary vein angioplasty to allow lead placement. Standard over-the-wire coronary artery balloon angioplasty catheters were used to dilate the vessel to 2.5 mm (n = 3) or 3.5 mm (n = 2).
Results:
Transvenous lead placement succeeds in >99% of patients. Four cases of target vein stenoses and one case of a vein of insufficient caliber were successfully treated by balloon angioplasty. There were no complications.
Conclusions:
Coronary vein angioplasty is an effective and safe technique to permit transvenous left ventricular pacing lead insertion in cases of target vein stenoses or insufficient target vein caliber.