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Persistent Left Superior Vena Cava in Pacemaker Implantation for Digoxin-Induced Complete Heart Block: Clinical

Abdalhakim Shubietah1, Mahmoud Doudein2, Islam Rajab3

  • 1Department of Internal Medicine Advocate Illinois Masonic Medical Center Chicago Illinois USA.

Clinical Case Reports
|March 5, 2025
PubMed

Insights

Persistent left superior vena cava (PLSVC) is a rare anomaly. Recognizing this venous variation is crucial for preventing complications during cardiovascular procedures like pacemaker implantation.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Congenital Anomalies

Background:

  • Duplication of the superior vena cava is a rare congenital anomaly.
  • This anatomical variation can complicate cardiovascular procedures, especially those requiring central venous access.
  • Persistent left superior vena cava (PLSVC) is an uncommon presentation of this anomaly.

Purpose of the Study:

  • To report a case of incidentally discovered PLSVC during pacemaker implantation.
  • To emphasize the importance of identifying venous anomalies in interventional cardiology.
  • To highlight the impact of PLSVC on surgical strategy and patient management.

Main Methods:

  • Case presentation of an 82-year-old female with comorbidities.
  • Incidental finding of PLSVC during pacemaker implantation.
  • Identification confirmed via contrast-enhanced CT scan.
  • Successful completion of the procedure by repositioning the implantation site.

Main Results:

  • Pacemaker implantation on the left side was initially unsuccessful due to resistance.
  • A persistent left superior vena cava was identified as the cause.
  • Successful pacemaker implantation was achieved on the right side.

Conclusions:

  • Early recognition of venous anomalies like PLSVC is vital during interventional procedures.
  • Awareness of congenital variations can prevent procedural complications and guide surgical planning.
  • This case underscores the importance of considering anatomical variations in patients with complex medical histories.

Keywords:
anatomical variationdouble SVCinterventional cardiologypacemakerpersistent left superior vena cava

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