title: Endovascular bi-ventricular pacing-defibrillator placement using a trans-atrial approach.
abstract: Venous access for pectoral pacemaker and defibrillator lead placement can be compromised by venous occlusion due to previous pacing leads, access ports for medications such as chemotherapy, dialysis access, and other causes. On rare occasion, a femoral access is utilized for device placement. We report here a patient without venous access to the heart from either above or below due to retroperitoneal fibrosis. A bi-ventricular pacing-defibrillator was placed using a direct trans-atrial approach with good results. This minimally invasive approach to device placement may be useful in patients with poor venous access and avoids the placement of epicardial hardware.
authors: Genesis Medical Center, Davenport, IA, USA. fondomg@yahoo.com
authors: Michael C
authors: MC
authors: Giudici
authors: Nicholas V
authors: NV
authors: Augelli
authors: Charles A
authors: CA
authors: Longo
authors: Cynthia J
authors: CJ
authors: Meierbachtol
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D006325:Heart Atria / Q000601:surgery*; D006333:Heart Failure / Q000150:complications / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D019919:Prosthesis Implantation / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000517:prevention & control*