Related Experiment Video
Updated: Nov 30, 2025
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Left-Sided Implantation of a Defibrillator Lead in Persistent Left Superior Vena Cava
Evelien De Roo1, Frederik Van Durme1, Becker Alzand1
1Department of Cardiology, AZ Glorieux, Ronse, Belgium.
Insights
Persistent left superior vena cava (PLSVC) is a rare congenital venous anomaly. This case highlights its incidental diagnosis during defibrillator lead implantation, noting potential challenges in lead placement.
Area of Science:
- Cardiology
- Vascular Anatomy
- Congenital Abnormalities
Background:
- Persistent left superior vena cava (PLSVC) is a congenital venous anomaly.
- Typically presents with an enlarged coronary sinus, often without hemodynamic compromise.
Purpose of the Study:
- To report a case of systolic heart failure with incidental PLSVC diagnosis during defibrillator lead implantation.
- To discuss diagnostic methods and implications for device implantation.
Main Methods:
- Echocardiography for coronary sinus assessment.
- Intraprocedural contrast injection for venous anomaly confirmation.
- Defibrillator lead implantation via PLSVC.
Main Results:
- PLSVC was diagnosed intraoperatively during defibrillator lead implantation.
- Technical feasibility of lead implantation through PLSVC was demonstrated.
- Potential difficulties in lead positioning due to anatomical variations were noted.
Conclusions:
- PLSVC can be incidentally identified during central venous access or pacemaker procedures.
- Echocardiography with contrast can aid in PLSVC diagnosis.
- While feasible, lead implantation via PLSVC may present positioning challenges.
Abstract:
Persistent left superior vena cava (PLSVC) is a congenital venous abnormality, characterized by an enlarged coronary sinus, in most cases without haemodynamic consequences. We report the case of a patient with systolic heart failure undergoing implantation of a defibrillator lead through a PLSVC which was diagnosed at the moment of implantation.
Learning Points:
Persistent left superior vena cava (PLSVC) can be incidentally diagnosed during a procedure such as a left-sided central venous line or pacemaker implantation, and can be confirmed by manual contrast injection during the procedure.An enlarged coronary sinus on echocardiography should raise suspicion of PLSVC which can be confirmed by administration of echo-contrast or agitated saline in the left arm.Although lead implantation through a PLSVC is technically feasible, difficulties in lead positioning may be encountered because of the acute angle between the origin of the coronary sinus and the tricuspid valve.
More Related Videos
12:45Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
07:41Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
Related Concept Videos
01:24Cardiac Catheterization III: Left Heart Catheterization
01:29Cardiomyopathy V: Interprofessional Care