title: Implantable cardioverter defibrillator lead implantation in patients with a persistent left superior vena cava--feasibility, chances, and limitations: representative cases in adults.
abstract: OBJECTIVE
  Device implantation may be challenging in patients with venous abnormalities. The most common congenital variation--frequently associated with other congenital abnormalities--is described as persistent left superior vena cava (PLSVC).
  
  
  RESULTS
  The present case series demonstrates successful implantable cardioverter defibrillator (ICD) lead implantation in the most common anatomic variations of PLSVC. All types of current ICD models (single and dual chamber, VDD, and cardiac resynchronization therapy devices) were used. Angiographic findings and implantation techniques (e.g. guiding and diagnostic catheters, wires, occlusion balloons, and rotation sequences) are presented in images and movie sequences.
  
  
  CONCLUSIONS
  Device implantation in patients with PLSVC may be complex but a successful transvenous approach is possible in most of the cases. Careful imaging prior to implantation procedure is essential for understanding the individual anatomy and in order to choose adequate material and implantation strategy.
authors.affiliation: Department of Internal Medicine and Cardiology,  University of Dresden, Heart Center, University Hospital, Fetscherstraße 76, 01307 Dresden,  Germany.
authors.forename: M
authors.initials: M
authors.lastname: Guenther
authors.forename: S
authors.initials: S
authors.lastname: Kolschmann
authors.forename: T P
authors.initials: TP
authors.lastname: Rauwolf
authors.forename: M
authors.initials: M
authors.lastname: Christoph
authors.forename: V
authors.initials: V
authors.lastname: Sandfort
authors.forename: R H
authors.initials: RH
authors.lastname: Strasser
authors.forename: C
authors.initials: C
authors.lastname: Wunderlich
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000628:therapy; D058406:Cardiac Resynchronization Therapy; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000628:therapy; D017147:Defibrillators, Implantable; D004567:Electrodes, Implanted; D005240:Feasibility Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D019919:Prosthesis Implantation / Q000379:methods*; D054079:Vascular Malformations / Q000000981:diagnostic imaging*; D014683:Vena Cava, Superior / Q000002:abnormalities* / Q000000981:diagnostic imaging