title: Biventricular ICD implantation using the iliofemoral approach: providing CRT to patients with occluded superior venous access.
abstract: A 32-year-old woman with a history of nonischemic dilated cardiomyopathy, left bundle branch block, left ventricular ejection fraction of 0.15, and New York Heart Association Class III congestive heart failure, despite optimal medical treatment, was referred for cardiac resynchronization therapy with implantation of an implantable cardioverter defibrillator. The patient had prior chemotherapy for non-Hodgkin's lymphoma and was shown to have chronic total occlusion of the superior vena cava (SVC) by magnetic resonance imaging. Cardiac resynchronization was accomplished with an iliofemoral approach without complications resulting in marked clinical improvement. We conclude that the iliofemoral approach allows transvenous implantation of cardiac resynchronization therapy in patients with superior vena cava occlusion.
authors.affiliation: Department of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Allred
authors.forename: Hugh T
authors.initials: HT
authors.lastname: McElderry
authors.forename: Harish
authors.initials: H
authors.lastname: Doppalapudi
authors.forename: Takumi
authors.initials: T
authors.lastname: Yamada
authors.forename: G Neal
authors.initials: GN
authors.lastname: Kay
mesh_terms: D000328:Adult; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000517:prevention & control*; D006801:Humans; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D013479:Superior Vena Cava Syndrome / Q000150:complications* / Q000175:diagnosis*; D016896:Treatment Outcome