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Persistent left superior vena cava: a problem in the transvenous pacing of the heart
T Dosios1, D Gorgogiannis, G Sakorafas
1Department of Surgery, Veterans Administration General Hospital, Athens, Greece.
Pacing and Clinical Electrophysiology : PACE
|March 1, 1991
Insights
Transvenous pacemaker implantation failed due to a persistent left superior vena cava (PLSVC) anomaly. Epicardial pacing was successfully used as an alternative for the patient.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Transvenous pacemaker implantation is a standard procedure.
- Anatomical variations can complicate device placement.
Observation:
- A patient presented with a persistent left superior vena cava (PLSVC).
- The PLSVC communicated with the right heart via the coronary sinus.
- Standard transvenous access from the right side was not feasible.
Findings:
- Transvenous pacemaker implantation was unsuccessful due to the anomalous venous anatomy.
- Epicardial pacing was successfully implemented as an alternative pacing strategy.
Implications:
- This case highlights the importance of recognizing congenital venous anomalies.
- Epicardial pacing serves as a viable alternative when transvenous access is compromised.
- Management strategies for cardiac device implantation may need adaptation for rare anatomical variations.
Abstract:
Transvenous pacemaker implantation was impossible from the right side in a patient with persistent left superior vena cava (PLSVC) as the two cavae communicated via the coronary sinus and entry into the right heart could not be achieved. Epicardial pacing was instituted.