scholarly journals A case report: upgrade to cardiac resynchronization therapy with a blocked persistent left-sided superior vena cava

2020 ◽  
Vol 4 (2) ◽  
pp. 1-5
Author(s):  
Kawan Fadhil Abdalwahid ◽  
Gavin S Chu ◽  
William B Nicolson
Keyword(s):  
Superior Vena Cava ◽  
De Novo ◽  
Superior Vena ◽  
Vena Cava ◽  
Good Health ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Lead Extraction ◽  
Biventricular Pacemaker ◽  
Pacemaker Leads

Abstract Background  Pacemaker-induced cardiomyopathy (PICM) can occur in up to 9% of patients having a pacemaker. Pacemaker-induced cardiomyopathy can be treated by upgrade to a biventricular pacemaker with a left ventricular (LV) lead implantation. The procedure can be technically challenging in patients with persistent left-sided superior vena cava (PLSVC). Case summary  We report the case of a 72-year-old gentleman with a PLSVC, who had a dual-chamber pacemaker implanted 15 years ago for complete heart block. After 12 years of good health, the gentleman developed breathlessness due to PICM. At upgrade to biventricular pacemaker, his coronary sinus was found to be occluded and a collateral branch was used to successfully position an LV lead. Marked clinical improvement was seen before representation with syncope after 2 years due to simultaneous failure of both LV and right ventricular leads. Subsequently, a right-sided de novo biventricular pacemaker was implanted. In this instance, the PLSVC was beneficial because it isolated the existing leads from the new implant, thereby reducing the risk of SVC obstruction. Discussion  Although implantation of pacemaker leads through a PLSVC constitutes a challenging procedure due to manoeuvring difficulties of the pacing leads into the cardiac chambers, in this particular case, the presence of PLSVC was beneficial because it meant that no leads were present in the true SVC, reducing the risk of occlusion and avoiding the need for lead extraction.

scholarly journals The use of laser lead extraction sheath in the presence of supra-cardiac occlusion of the central veins for cardiac implantable electronic device lead upgrade or revision

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251829
Author(s):  
Sameer Al-Maisary ◽  
Gabriele Romano ◽  
Matthias Karck ◽  
Raffaele De Simone ◽  
Jamila Kremer
Keyword(s):  
Superior Vena Cava ◽  
Complication Rate ◽  
Electronic Device ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Access ◽  
Left Ventricular ◽  
Right Atrial ◽  
Lead Extraction ◽  
Severe Stenosis

Background The implantation of cardiac implantable electronic devices (CIED) has increased in the last decades with improvement in the quality of life of patients with cardiac rhythm disorders. The presence of bilateral subclavian, innominate or superior vena cava obstruction is a major limitation to device revision and/or upgrade. Methods and material This is retrospective study of patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Spectranetics Corporation, Colorado Springs, USA) with lead revision or upgrade using the laser sheath as a guide rail. Patients with known occlusion, severe stenosis or functional obstruction of the venous access vessels with indwelling leads were included in this study. Results 106 patients underwent percutaneous LLE with lead revision and/or upgrade. Preoperative known complete occlusion or severe stenosis of access veins was present in 23 patients (21.5%). More patients with implantable cardioverter-defibrillator (ICD) underwent LLE (64.1%) than patients with CRT-Ds (24.5%) and pacemaker patients (11.3%). In total 172 leads were extracted: 79 (45.9%) single-coil defibrillator leads, 35 (20.3%) dual-coil defibrillator leads, 31 (18.0%) right atrial leads, 24 (13.9%) right ventricular leads and three (1.7%) malfunctional coronary sinus left ventricular pacing leads. The mean age of leads was 99.2±65.6 months. The implantation of new leads after crossing the venous stenosis/obstruction was successful in 98 (92.4%) cases. Postoperative complications were pocket hematoma in two cases and wound infection in one case. No peri-operative and no immediate postoperative death was recorded. One intraoperative superior vena cava tear was treated by immediate thoracotomy and surgical repair. Conclusion In a single-center study on LLE in the presence of supra-cardiac occlusion of the central veins for CIED lead upgrade and revision we could demonstrate a low procedural complication rate with no procedural deaths. Most of the leads could be completely extracted to revise or upgrade the system. Our study showed a low complication rate, with acceptable mortality rates.

Persistent left superior vena cava transvenous lead extraction: A European experience

2021 ◽  
Author(s):  
Zaki Akhtar ◽  
Manav Sohal ◽  
Christoph T. Starck ◽  
Patrizio Mazzone ◽  
Francesco Melillo ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Lead Extraction ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
European Experience

scholarly journals Trans-septal left ventricular endocardial pacing through a persistent left-sided superior vena cava

EP Europace ◽  
2009 ◽  
Vol 11 (12) ◽  
pp. 1709-1711 ◽  
Author(s):  
P. A. Scott ◽  
P. R. Roberts ◽  
J. M. Morgan
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Left Ventricular ◽  
Endocardial Pacing

Superior Vena Cava Syndrome Induced by Endocardial Defibrillator and Pacemaker Leads

2007 ◽  
Vol 99 (12) ◽  
pp. 1765-1767 ◽  
Author(s):  
Arash Aryana ◽  
Kristi D. Sobota ◽  
Dennis J. Esterbrooks ◽  
Andrew I. Gelbman
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Vena Cava ◽  
Pacemaker Leads ◽  
Vena Cava Syndrome

scholarly journals De novo mosaic and partial monosomy of chromosome 21 in a case with superior vena cava duplication

2020 ◽  
Author(s):  
Abul Kalam Azad ◽  
Lindsay Yanakakis ◽  
Samantha Issleb ◽  
Jessica Turina ◽  
Kelli Drabik ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
De Novo ◽  
Superior Vena ◽  
Vena Cava ◽  
Chromosome 21 ◽  
Chromosomal Microarray ◽  
Chromosomal Microarray Analysis ◽  
Chromosomal Anomalies ◽  
Partial Monosomy ◽  
Increased Risk

Abstract Background Full or partial monosomy of chromosome (chr) 21 is a very rare abnormal cytogenetic finding. It is characterized by variable sizes and deletion breakpoints on the long arm (q) of chr 21 that lead to a broad spectrum of phenotypes that include an increased risk of birth defects, developmental delay and intellectual deficit. Case presentation: We report a 37-year-old G1P0 woman initially screened by non-invasive prenatal testing with no positive findings that was followed by an 18-week anatomy scan with a fetal finding of duplication of the superior vena cava (SVC). The medical and family history was otherwise uneventful. After appropriate genetic counseling, amniocentesis was performed to evaluate suspected chromosomal anomalies. Conclusions Fluorescent in situ hybridization revealed loss of one chr 21 signal that was further delineated by chromosomal microarray analysis on uncultured amniocytes as a terminal 10 Mb deletion on chr 21q. Karyotype and microarrays on cultured amniocytes showed two cell lines for a mosaic 21q terminal deletion and monosomy 21. The combined molecular cytogenetics results reported as mos 45,XX,-21[10]/46,XX,del(21)(q22)dn[20].nuc ish(D21S342/D21S341/D21S259 × 1)[100].arr[GRCh37] 21q11.2q22.12(15412676_36272993)x1 ~ 2,21q22.12q22.3(36431283_47612400)x1. Parental chromosomal analysis revealed normal karyotypes. Thus, this was a de novo mosaic full and partial monosomy of chr 21 in a case with SVC duplication. Despite the association of congenital heart disease with monsomy 21 we could not find any published literature or online databases for this cytogenetic abnormality. The patient terminated the pregnancy following the abnormal molecular cytogenetic results due to the possible challenges the baby would face if carried to term.

Mechanism of hemodynamic responses to occlusion of the descending thoracic aorta

1980 ◽  
Vol 238 (4) ◽  
pp. H423-H429 ◽  
Author(s):  
O. Stokland ◽  
M. M. Miller ◽  
A. Ilebekk ◽  
F. Kiil
Keyword(s):  
Inferior Vena Cava ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena ◽  
Vena Cava ◽  
Spinal Column ◽  
Left Ventricular Pressure ◽  
Left Ventricular ◽  
Aortic Occlusion ◽  
Systolic Volume

To examine left ventricular responses to aortic occlusion, changes in end-diastolic volume (EDV) and end-systolic volume (ESV) were estimated by ultrasonic recordings of myocardial distances in atropinized open-chest dogs. During aortic occlusion EDV and ESV increased equally, systolic left ventricular pressure (LVP) rose by 86 +/- 8 mmHg, and blood flow more than doubled in the superior vena cava and fell by 90% in the inferior vena cava. During combined occlusion of aorta and inferior vena cava, systolic LVP and superior vena cava flow did not rise above control and EDV declined. By infusing 25 +/- 2 ml/kg body wt of blood during combined occlusion, the effects of aortic occlusion could be reproduced; control values before blood infusion were reestablished by withdrawal of only one-third of the infused volume, indicating a shunt line along the spinal column. Thus during aortic occlusion, transfer of blood accounts for the rise in EDV and increased activation of the Frank-Starling mechanism; increased afterload raises ESV as much as EDV in anesthetized dogs not subjected to sympathetic stimulation. Consequently, stroke volume is maintained and systolic LVP increased.

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