Coronary Sinus Reducer Implantation in a Patient With Pre-Existing Left Ventricular Lead

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Coronary sinus reducer (CSR) implantation is a novel therapy for refractory angina.
• Indications for cardiac resynchronization therapy (CRT) are expanding.
• Safety data for CSR implantation in patients with prior left ventricular (LV) leads are limited.

Observation:

• A case report details the successful implantation of a CSR device in a 79-year-old patient with ischemic cardiomyopathy and a pre-existing LV lead.
• The patient presented with symptoms of refractory angina.

Findings:

• CSR implantation in the presence of an LV lead is technically feasible.
• Potential for LV lead trapping between the CSR stent and coronary sinus exists, potentially complicating future lead extraction.
• Long-term effects of LV leads on CSR endothelialization and device failure rates are unknown.

Implications:

• This case highlights the feasibility of CSR implantation in patients with prior LV leads.
• Further research is needed to assess the long-term safety and efficacy of CSR in this patient population.
• Consideration of potential lead-device interactions is crucial for procedural planning and patient management.