title: Successful implantation of a permanent pacemaker through a persistent left superior vena cava by using a right subclavian approach.
abstract: BACKGROUND
  Persistent left superior vena cava, a rare congenital abnormality, can complicate placement of pacemaker leads through the subclavian vein. A left-sided approach is usually preferable in such cases.
  
  
  METHODS
  We reported a case in which we began a single-chamber pacemaker implantation procedure via a right subclavian approach (because of scarring beneath the left clavicle) and then discovered intraoperatively that the patient had a persistent left superior vena cava. After a few attempts, we succeeded in placing the head of the electrode in the septum, near the top of the right ventricle, and the rest of the procedure was completed without complication.
  
  
  CONCLUSIONS
  To our knowledge, this is the first reported case of pacemaker implantation, with passive electrode, through a persistent left superior vena cava via the right subclavian vein. This case demonstrates that such an approach, when necessary, can be used successfully.
authors: Military Medical Academy, Clinic for Cardiology, Belgrade, Serbia. zockydr@gmail.com
authors: Zoran
authors: Z
authors: Jović
authors: Zdravko
authors: Z
authors: Mijailović
authors: Slobodan
authors: S
authors: Obradović
authors: Dragan
authors: D
authors: Tavciovski
authors: Radomir
authors: R
authors: Matunović
authors: Sinisa
authors: S
authors: Rusović
authors: Predrag
authors: P
authors: Djurić
mesh_terms: D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D013350:Subclavian Vein / Q000601:surgery*; D014683:Vena Cava, Superior / Q000002:abnormalities*