Slittable sheath supported right ventricular pacing lead implantation in persistent left superior vena cava with absent right superior vena cava: a case report

Journal of Medical Case Reports

Case Report

David Šipula¹  Tomáš Grézl¹  Jiří Vrtal¹  Jan Václavík²  Jiří Plášek³ 

[1] Department of Internal Medicine and Cardiology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic;Department of Internal Medicine and Cardiology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic;Centre for Research on Internal Medicine and Cardiovascular Diseases, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic;Department of Internal Medicine and Cardiology, University Hospital Ostrava, 17. Listopadu 1790/5, 708 52, Ostrava, Czech Republic;Department of Cardiology, Institute for Clinical and Experimental Medicine, Vídeňská 1958, 140 21, Prague, Czech Republic;Centre for Research on Internal Medicine and Cardiovascular Diseases, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00, Ostrava, Czech Republic;

关键词: Cardiac pacing;    Persistent left superior vena cava;    PLSVC;    Right superior vena cava;    RSVC;    Slittable sheath;   

DOI  :  10.1186/s13256-023-04073-y

 received in 2021-12-28, accepted in 2023-07-10,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPersistent left superior vena cava (PLSVC) is the most common variant of systemic venous drainage. In the absence of the right superior vena cava (RSVC), implantation of a right ventricular pacing lead may be challenging. Therefore specific implantation techniques and experiences in PLSVC are worth reporting.Case presentationWe present a case report of a 90-year-old Caucasian female patient with PLSVC during single chamber pacemaker implantation due to the third-degree atrioventricular block. With common implantation techniques, we did not even reach the right ventricle. Therefore slittable CPS Direct ™ Universal sheath was employed to overcome the acute angle from PLSVC to tricuspid valve and ensure more fixation stability for longer 100-cm right ventricular lead placement.ConclusionThis case demonstrates safe implantation of 100-cm long right ventricular bipolar active fixation pacing lead using common slittable CPS Direct ™ Universal sheath after failed attempts with „C“ and „J“ stylet shaped electrode. This sheath provides different angle towards tricuspid valve and more fixation stability in patient with PLSVC and absent connection to right atrium.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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