title: Efficacy of coronary venoplasty for left ventricular lead implantation.
abstract: BACKGROUND
  Optimal target vein selection for the pacing lead results in a better outcome, but left ventricular (LV) variability limits this selection. The aim of the present study was to investigate the efficacy of coronary venoplasty for insertion of a LV lead.
  
  
  RESULTS
  Transvenous LV lead placement was attempted in 208 consecutive patients from November 2002 to January 2007, with success in 206 patients (99%). Retrospective analysis of the cardiac resynchronization therapy system implantation showed that 4 of the 206 patients (1.9%) required coronary venoplasty for insertion of the pacing lead implant. Using coronary balloon angioplasty catheters of 2.5 mm (2 patients), 3.0 mm (1 patient) and 4.0 mm (1 patient), each target vein was dilated. Of 4 patients, stenoses in 3 were dilated by balloon angioplasty only. However, focal stenosis of 1 patient was not able to be dilated due to severe stenosis. Therefore, part of the lesion was sharpened by rotational atherectomy and the stenosis was successfully dilated. The LV pacing lead could then be inserted and no complications occurred.
  
  
  CONCLUSIONS
  Venoplasty for stenosis was effective in allowing deployment of a LV lead into a target vein in some patients. The safety and complications of the procedure remain unclear.
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Masahiko
authors.initials: M
authors.lastname: Goya
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shirai
authors.forename: Koyu
authors.initials: K
authors.lastname: Sakai
authors.forename: Masashi
authors.initials: M
authors.lastname: Iwabuchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yasumoto
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nosaka
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D002304:Cardiac Pacing, Artificial; D023921:Coronary Stenosis / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial