title: [Femoral vein guidance for pipe-shaped coronary sinus cannulation and epicardial left ventricular lead placement using left subclavian vein approach].
abstract: Variations in coronary sinus (CS) anatomy can make subclavian vein approach dif?cult or even impossible for LV lead delivery. A combination of interventional and electrophysiological methods is therefore the state of art technique for implantation of LV leads. A 52 year-old male patient with ischemic dilated cardiomyopathy (LVEF: 15%, QRS: 160 msec) who was symptomatic under optimal medical therapy was hospitalized for implantation of cardiac resynchronization therapy. Although right ventricular and atrial electrodes were implanted successfully, we had difficulty during placement of the left ventricular electrode. There was an anatomical variation in CS with a piped shape, which prevented cannulation from the superior approach. We describe a practical method for guidance of transfemoral route for pipe-shaped CS cannulation and epicardial placement of LV lead with superior approach.
authors.affiliation: Department Of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey. Dru_canpolat@yahoo.com
authors.forename: Uğur
authors.initials: U
authors.lastname: Canpolat
authors.forename: Levent
authors.initials: L
authors.lastname: Şahiner
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ali
authors.initials: A
authors.lastname: Oto
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D058406:Cardiac Resynchronization Therapy; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000628:therapy*; D054326:Coronary Sinus / Q000002:abnormalities*; D005268:Femoral Vein; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000628:therapy; D013350:Subclavian Vein