Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

Open Access 27-08-2021 | Image Puzzle – Answer

The lead leads the way

Auteurs: S. Borges, J. I. Moreira

Gepubliceerd in: Netherlands Heart Journal

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
insite
ZOEKEN

Answer

To our surprise, the guide wire was advanced, entered the subclavian vein and descended parallel to the spine without crossing over to the right side. Thereafter, the guide wire traversed the coronary sinus (CS) and terminated in the right atrium. Venography of the left subclavian vein was performed, showing the presence of an isolated persistent left superior vena cava (PLSVC), with absence of the innominate vein (Fig. 1).
PLSVC is a rare congenital vascular anomaly, occurring in 0.3–0.5% of individuals in the general population [1]. These challenging anatomical variants, often asymptomatic and an incidental finding at the time of the procedure, can pose difficulties and complications during central venous cannulation or device implantation, such as arrhythmia, cardiac tamponade, CS dissection and thrombosis. Additionally, lead insertion may be technically challenging due to misalignment of the CS ostium in relation to the tricuspid valve [2].
However, the development of new materials and techniques in recent years has enabled the successful and safe implantation of cardiac devices [2]. Our patient remains asymptomatic and pacemaker interrogation revealed normal parameters during the follow-up period.
Even though permanent pacemaker implantation through the CS via the PLSVC is technically demanding, long-term results are good [3], as observed in our case. However, these patients need frequent surveillance during the initial period.

Conflict of interest

S. Borges and J.I. Moreira declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Onze productaanbevelingen

Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Literatuur
1.
go back to reference Povoski SP, Khabiri H. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011;9:173. CrossRef Povoski SP, Khabiri H. Persistent left superior vena cava: review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011;9:173. CrossRef
2.
go back to reference Ratliff LH, Yousufuddin M, Lieving RW, et al. Persistent left superior vena cava: case reports and clinical implications. Int J Cardiol. 2006;113:242–6. CrossRef Ratliff LH, Yousufuddin M, Lieving RW, et al. Persistent left superior vena cava: case reports and clinical implications. Int J Cardiol. 2006;113:242–6. CrossRef
3.
go back to reference Sinha SK, Goel A, Razi M, et al. Permanent pacemaker implantation in patients with isolated persistent left superior vena cava from a right-sided approach: technical considerations and follow-up outcome. Cardiol Res. 2019;10:18–23. CrossRef Sinha SK, Goel A, Razi M, et al. Permanent pacemaker implantation in patients with isolated persistent left superior vena cava from a right-sided approach: technical considerations and follow-up outcome. Cardiol Res. 2019;10:18–23. CrossRef
Metagegevens
Titel
The lead leads the way
Auteurs
S. Borges
J. I. Moreira
Publicatiedatum
27-08-2021
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-021-01625-z