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Russell J, Koroma T, Conteh V, Coker J, Conteh S, Bharat K, Mahdi O. Persistent left superior vena cava in a 29-year-old lady with Ebstein's anomaly and complete heart block. A case report and literature review. Ann Med Surg (Lond) 2022; 78:103884. [PMID: 35734721 PMCID: PMC9207079 DOI: 10.1016/j.amsu.2022.103884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- J.B.W. Russell
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, Connaught Teaching Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Internal Medicine, Choithrams Memorial Hospital, Freetown, Sierra Leone
- Corresponding author. Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone.
| | - T.R. Koroma
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, Connaught Teaching Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - V. Conteh
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, Connaught Teaching Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Department of Internal Medicine, Choithrams Memorial Hospital, Freetown, Sierra Leone
| | - J. Coker
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, Connaught Teaching Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - S. Conteh
- Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone
- Department of Internal Medicine, Connaught Teaching Hospital, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Kumar Bharat
- Department of Internal Medicine, Choithrams Memorial Hospital, Freetown, Sierra Leone
| | - O.Z. Mahdi
- Department of Internal Medicine, Choithrams Memorial Hospital, Freetown, Sierra Leone
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Caravati F, Golino M, Damiani G, Oliviero G, Vecchi AL, Giuntini C, Paganini EM, De Ponti R. Active fixation coronary sinus lead in a patient with persistence of left superior vena cava. Clin Case Rep 2020; 8:1642-1646. [PMID: 32983468 PMCID: PMC7495820 DOI: 10.1002/ccr3.2966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/08/2020] [Accepted: 04/23/2020] [Indexed: 11/30/2022] Open
Abstract
In patients with PLSVC, the use of an active fixation lead (like the Medtronic "Attain Stability") on the coronary sinus can lead to a successful and safe cardiac resynchronization, facilitating its positioning with a low long-term displacement rate.
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Affiliation(s)
- Fabrizio Caravati
- Department of Heart and VesselsOspedale di CircoloUniversity of InsubriaVareseItaly
| | - Michele Golino
- Department of Heart and VesselsOspedale di CircoloUniversity of InsubriaVareseItaly
| | - Giulia Damiani
- Department of Heart and VesselsOspedale di CircoloUniversity of InsubriaVareseItaly
| | - Giada Oliviero
- Department of Heart and VesselsOspedale di CircoloUniversity of InsubriaVareseItaly
| | | | - Chiara Giuntini
- Department of Heart and VesselsOspedale di CircoloUniversity of InsubriaVareseItaly
| | | | - Roberto De Ponti
- Department of Heart and VesselsOspedale di CircoloUniversity of InsubriaVareseItaly
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The incidental finding of a persistent left superior vena cava: implications for primary care providers-case and review. Case Rep Med 2015; 2015:198754. [PMID: 25632278 PMCID: PMC4302353 DOI: 10.1155/2015/198754] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/05/2014] [Indexed: 01/31/2023] Open
Abstract
Persistent left superior vena cava (PLSVC) is the most common thoracic venous anomaly and is a persistent congenital remnant of the vena caval system from early cardiac development. Patients with congenital anomalous venous return are at increased risk of developing various cardiac arrhythmias, due to derangement of embryologic conductive tissue during the early development of the heart. Previously this discovery was commonly made during the placement of pacemakers or defibrillators for the treatment of the arrhythmias, when the operator encountered difficulty with proper lead deployment. However, in today's world of various easily obtainable imaging modalities, PLSVC is being discovered more and more by primary care providers during routine testing or screening for other ailments. Given the known association between anomalous venous return and the propensity for cardiac arrhythmias, we review the embryology of PLSVC and the mechanisms by which it leads to conduction abnormalities. We also provide the practitioner with recommendations for certain baseline cardiac observations and suggestions for proper surveillance in hopes that better understanding will reduce unnecessary and potentially harmful testing, premature subspecialty referral, and unneeded patient anxiety.
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Williams TA, Abe O, Mitre CA, Kassotis J. Low defibrillation threshold in a patient with a dual-coil defibrillator lead implanted through a persistent left superior vena cava. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2012; 35:e274-5. [PMID: 22650311 DOI: 10.1111/j.1540-8159.2012.03432.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Several reports have described the successful insertion of implantable cardioverter defibrillator (ICD) in patients with a persistent left superior vena cava (PLSVC). The implanters have used various techniques to achieve appropriate lead placement. In our case, the use of a long sheath, guided by a deflectable catheter, not only facilitated proper implantation of the lead, but also provided a unique position of the dual-coil lead. This resulted in a very low defibrillation threshold (DFT). We describe a case of a patient found to have a PLSVC at implant who after successful insertion of the ICD exhibited DFT ≤ 5 J.
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Affiliation(s)
- Thomas A Williams
- Department of Electrophysiology, SUNY Downstate Medical Center, Brooklyn, New York, USA
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Daccarett M, Pai RK, Abedin M, Segerson NM, Hamdan MH. A novel technique for right ventricular lead placement in a patient with a persistent left superior vena cava. Europace 2007; 9:200-1. [PMID: 17267517 DOI: 10.1093/europace/eul183] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Persistent left superior vena cava is the most common venous anomaly of the thorax. If unrecognized, it could lead to catheter malplacement and even vascular injuries. We describe a novel use of a Worley sheath for the delivery of a right ventricular (RV) endocardial pacing lead in a 65-year-old male with a persistent left superior vena cava. After failed attempts with the standard stylets, use of the Worley sheath aided successful lead deployment. We conclude that when used appropriately, the Worley sheath is a tool that could be helpful in pacing lead placement in patients with persistent left superior vena cava.
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Affiliation(s)
- Marcos Daccarett
- Division of Cardiac Electrophysiology, University of Utah Health Science Center/Salt Lake City VA Administration Hospital, 30 North 1900 East, 4A100, Salt Lake City, UT 84132, USA
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