title: Implantation of a cardiac resynchronization therapy-defibrillator device in a patient with persistent left superior vena cava.
abstract: Presence of a persistent left superior vena cava (PLSVC) is generally clinically asymptomatic and discovered incidentally during central venous catheterization. However, PLSVC may cause technical difficulties during cardiac device implantation. An 82-year-old man with heart failure symptoms and an ejection fraction (EF) of 20% was scheduled for resynchronization therapy-defibrillator device (CRT-D) implantation. A PLSVC draining via a dilated coronary sinus into an enlarged right atrium was diagnosed. First, an active-fixation right ventricular lead was inserted into the right atrium through the PLSVC. The stylet was preshaped to facilitate its passage to the right ventricular apex. An atrial lead was positioned on the right atrium free wall, and an over-the-wire coronary sinus lead deployed to a stable position. CRT-D implantation procedure was successfully completed.
authors.affiliation: Department of Cardiology, Baskent University Faculty of Medicine Hospital, Ankara, Turkey.
authors.forename: İlyas
authors.initials: İ
authors.lastname: Atar
authors.affiliation: Department of Cardiology, Baskent University Faculty of Medicine Hospital, Ankara, Turkey.
authors.forename: Emir
authors.initials: E
authors.lastname: Karaçağlar
authors.affiliation: Department of Cardiology, Baskent University Faculty of Medicine Hospital, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Özçalık
authors.affiliation: Department of Cardiology, Baskent University Faculty of Medicine Hospital, Ankara, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Özin
authors.affiliation: Department of Cardiology, Baskent University Faculty of Medicine Hospital, Ankara, Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Müderrisoğlu
mesh_terms: D000369:Aged, 80 and over; D058409:Cardiac Resynchronization Therapy Devices; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D019919:Prosthesis Implantation; D013479:Superior Vena Cava Syndrome / Q000601:surgery* / Q000628:therapy*; D014683:Vena Cava, Superior / Q000601:surgery*