[Pacemaker implantation via a persistent left superior vena cava in atresia of the true superior vena cava].
Implantation of a single-chamber pacemaker was planned in an 83-year-old woman with sick-sinus syndrome causing dizziness, bradycardia and tachycardia. After puncture of the right subclavian vein it proved impossible to advance a guide-wire into the superior vena cava, under fluoroscopy the wire always being seen to coil in the left subclavian vein and hence passing into a caudally directed vein. This vessel proved to be a persistent left superior vena cava (PLSVC) which connected to a markedly dilated coronary sinus (2 cm diameter) opening into the right atrium. An 85-cm electrode was then passed via the PLSVC and right atrium into the right ventricle without difficulty and was anchored in its apex. Echocardiography failed to reveal any further anomaly. Three-dimensional computed tomographic reconstruction established atresia or agenesis of the (right) superior vena cava. Normal pacemaker function freed the patient of all symptoms postoperatively.
Antretter
H
H
Abteilung für Herzchirurgie, I. Chirurgischen Universitätsklinik, Innsbruck.
Cottogni
M
M
Oberhauser
A
A
Lhotta
K
K
Furtwängler
W
W
D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010138:Pacemaker, Artificial; D012804:Sick Sinus Syndrome / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging
Schrittmacherimplantation über eine persistierende linke obere Hohlvene bei Atresie der eigentlichen Vena cava superior.