scholarly journals Luminal vena cava superior and right atrial obstruction associated with severe tricuspid valve stenosis due to endocardial pacemaker leads: an extremely rare complication of permanent pacemakers

2010 ◽  
Vol 11 (5) ◽  
pp. E22-E22 ◽  
Author(s):  
Ümit Güray ◽  
Yeşim Güray ◽  
Ayça Boyaci ◽  
Burcu Demirkan ◽  
Fehmi Katircioglu ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Rare Complication ◽  
Vena Cava ◽  
Right Atrial ◽  
Vena Cava Superior ◽  
Pacemaker Leads ◽  
Tricuspid Valve Stenosis

scholarly journals Obstruction of the inferior vena cava following bicaval orthotopic heart transplantation: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Anas Abudan ◽  
Brent Kidd ◽  
Peter Hild ◽  
Bhanu Gupta
Keyword(s):  
Inferior Vena Cava ◽  
Heart Transplantation ◽  
Inferior Vena ◽  
Rare Complication ◽  
Vena Cava ◽  
Case Series ◽  
Transoesophageal Echocardiography ◽  
Right Atrial ◽  
Orthotopic Heart Transplantation ◽  
Eustachian Valve

Abstract Background Inferior vena cava (IVC) obstruction is a rare complication of orthotopic heart transplantation (OHT) and is unique to bicaval surgical technique. The clinical significance, diagnosis, complications, and management of post-operative IVC anastomotic obstruction have not been adequately described. Case summary Two patients with end-stage heart failure presented for bicaval OHT. Post-operative course was complicated with shock refractory to fluid resuscitation and inotropic/vasopressor support. Obstruction at the IVC-right atrial (RA) anastomosis was diagnosed on transoesophageal echocardiography (TOE), prompting emergent reoperation. In both cases, a large donor Eustachian valve was found to be restricting flow across the IVC-RA anastomosis. Resection of the valve resulted in relief of obstruction across the anastomosis and subsequent improvement in haemodynamics and clinical outcome. Discussion Presumably rare, we present two cases of IVC obstruction post-bicaval OHT. Inferior vena cava obstruction is an under-recognized cause of refractory hypotension and shock in the post-operative setting. Prompt recognition using TOE is crucial for immediate surgical correction and prevention of multi-organ failure. Obstruction can be caused by a thickened Eustachian valve caught in the suture line at the IVC anastomosis, which would require surgical resection.

3D mapping for the identification of the fossa ovalis in left atrial ablation procedures: a pilot study of a first step towards an electroanatomic-guided transseptal puncture

EP Europace ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 732-738 ◽  
Author(s):  
Martin Eichenlaub ◽  
Reinhold Weber ◽  
Jan Minners ◽  
Hans-Jürgen Allgeier ◽  
Amir Jadidi ◽  
...  
Keyword(s):  
Left Atrial ◽  
Low Voltage ◽  
Vena Cava ◽  
Persistent Atrial Fibrillation ◽  
Right Atrial ◽  
3D Mapping ◽  
Transseptal Puncture ◽  
Atrial Ablation ◽  
Vena Cava Superior ◽  
Mapping Catheter

Abstract Aims Transseptal puncture (TP) for left atrial (LA) catheter ablation procedures is routinely performed under fluoroscopic guidance. To decrease radiation exposure and increase safety alternative techniques are desirable. The aim of this study was to assess whether right atrial (RA) electroanatomic 3D mapping can reliably identify the fossa ovalis (FO) in preparation of TP. Methods and results Between May 2019 and August 2019, electroanatomic RA mapping was performed before TP in 61 patients with paroxysmal or persistent atrial fibrillation. Three electroanatomic methods for FO identification, mapping catheter-induced FO protrusion, electroanatomic-guided analysis, and voltage mapping, were evaluated and compared with transoesophageal echocardiography (TOE). Mapping catheter-induced FO protrusion was feasible in 60 patients (98%) with a mean displacement of 6.8 ± 2.5 mm, confirmed by TOE, and proofed to be the most valuable and easiest marker for FO identification. Electroanatomic-guided analysis localized the FO midpoint consistently in the lower half (43 ± 7%) and posterior (18.2 ± 4.4 mm) to a line between coronary sinus and vena cava superior. Analysis of RA voltage maps during sinus rhythm (n = 40, low-voltage cut-off value 1.0 and 1.5 mV) allowed secure FO recognition in 33% and 18%, only. A step-by-step approach, combining FO protrusion (first step) with anatomy criteria in case of protrusion failure (second step) would have allowed for the correct localization of a TP site within the FO in all patients. Conclusion Right atrial electroanatomic 3D mapping prior to TP proofed to be a simple tool for FO identification and may potentially be of use in the safe and radiation-free performance of TP prior to LA ablation procedures.

Repair of a mixed form of supracardiac total anomalous pulmonary venous connection

2020 ◽  
pp. 1-3
Author(s):  
Yuki Kawasaki ◽  
John N. Dentel ◽  
Henry L. Walters ◽  
James M. Galas ◽  
Daisuke Kobayashi
Keyword(s):  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Right Atrial ◽  
Pulmonary Venous Obstruction ◽  
Mixed Form ◽  
Vertical Vein ◽  
Vena Cava Superior ◽  
Anomalous Pulmonary Venous Connection

Abstract Total anomalous pulmonary venous connection is a rare congenital heart defect. We report an infant with a mixed form of supracardiac TAPVC, in whom all pulmonary veins, except the right upper, entered a pulmonary venous confluence that is connected to a vertical vein and drained into the superior vena caval–right atrial junction. Several segmental right upper pulmonary veins entered the superior vena cava, superior to the entry of the vertical vein. Surgical repair consisted of the Warden procedure combined with direct anastomosis of the vertical vein to the left atrium. Separate pulmonary venous drainage pathways decreased the risk of post-operative pulmonary venous obstruction. Our patient had an uneventful post-operative course and encouraging 2-month follow-up echocardiography. Careful follow-up is warranted to detect post-operative complications, including obstruction of the pulmonary venous and cavoatrial anastomoses.

Peripherally Inserted Central Catheter-Induced Right Atrium Thrombosis and Superior Vena Cava Dissection

2017 ◽  
Vol 22 (1) ◽  
pp. 20-21
Author(s):  
Priyank Shah ◽  
Rahul Vasudev ◽  
Raja Pullatt ◽  
Fayez Shamoon
Keyword(s):  
Pulmonary Embolism ◽  
Superior Vena Cava ◽  
Rare Complication ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Access ◽  
Right Atrial ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Picc Line

Abstract A 42-year-old woman with past medical history of intravenous drug abuse was admitted to hospital with fever and heart murmur. A peripherally inserted central catheter (PICC) was inserted because the patient had poor venous access. Transesophageal echocardiography was done to rule out infective endocarditis. The test showed thrombus attached to the PICC line. Thrombus arising from a catheter is known complication of PICCs. Classifications of right heart thromboembolism (RHTE) are based on morphology. Type A thrombi are highly mobile and may prolapse through the tricuspid valve. Conversely, type B thrombi are attached to the right atrial or ventricular wall and may originate in association with foreign bodies or in structurally abnormal chambers. RHTEs are associated with pulmonary embolism in approximately 4%–6% of cases and increase the 3-month mortality rate from 16% to 29%. On echocardiography, partial dissection of the superior vena cava (SVC) was also noted. This is a very rare complication of PICC. To the best of our knowledge this is the first reported case of PICC-induced thrombosis with partial dissection of SVC. The PICC line was removed and echocardiography postremoval did not show any thrombus. The patient remained asymptomatic without any signs of hemodynamically significant pulmonary embolism. SVC dissection was also managed conservatively. Use of central venous catheters in clinical practice is increasing but it is not a benign procedure. It may be associated with serious complications.

scholarly journals Unusual Case of Colonized Pacemaker Lead Presenting with Endocarditis, Hemoptysis and Tricuspid Valve Stenosis

2011 ◽  
Vol 18 (3) ◽  
pp. e48-e49
Author(s):  
Jean-Francois Morin ◽  
Richard Sheppard ◽  
Patrick Chamoun
Keyword(s):  
Tricuspid Valve ◽  
Unusual Case ◽  
Present Report ◽  
Pacemaker Lead ◽  
Aggressive Treatment ◽  
Surgical Extraction ◽  
Pacemaker Leads ◽  
Tricuspid Valve Stenosis

The present report is the first to describe a case of hemoptysis caused by an endocardial pacemaker lead. In addition, the patient presented with endocarditis and tricuspid valve stenosis. Aggressive treatment consisted of surgical extraction of two pacemaker leads and one pacemaker battery, replacement of the tricuspid valve and implantation of a DDD-R epicardial pacemaker.

Acquired Tricuspid Valve Stenosis Associated with Two Ventricular Endocardial Pacing Leads in a Dog

2015 ◽  
Vol 51 (3) ◽  
pp. 167-170 ◽  
Author(s):  
Emily Tompkins ◽  
Michelle I. Dulake ◽  
Shadie Ghaffari ◽  
Reid K. Nakamura
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Rare Complication ◽  
Tricuspid Valve Annulus ◽  
Pacing Lead ◽  
Spectral Doppler ◽  
Valve Annulus ◽  
Endocardial Pacing ◽  
Tricuspid Valve Stenosis ◽  
Pacing Leads

Acquired tricuspid valve stenosis (TVS) is a rare complication of endocardial pacing lead implantation in humans that has only been described once previously in the veterinary literature in a dog with excessive lead redundancy. A 12 yr old terrier presented with right-sided congestive heart failure 6 mo after implantation of a second ventricular endocardial pacing lead. The second lead was placed due to malfunction of the first lead, which demonstrated abnormally low impedance. Transthoracic echocardiography identified hyperechoic tissue associated with the pacing leads as they crossed the tricuspid valve annulus as well as a stenotic tricuspid inflow pattern via spectral Doppler interrogation. Medical management was ultimately unsuccessful and the dog was euthanized 6 wk after TVS was diagnosed. The authors report the first canine case of acquired TVS associated with two ventricular endocardial pacing leads.

scholarly journals Right Heart Morphology of Candidate Patients for Transcatheter Tricuspid Valve Interventions

2021 ◽  
Author(s):  
Omar K. Khalique ◽  
Vladimir Jelnin ◽  
Andreas Hueske ◽  
Mathew Lawlor ◽  
Martin B. Leon ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Heart Function ◽  
Cardiac Computed Tomography ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Right Heart ◽  
Cardiac Computed Tomography Angiography ◽  
The Right ◽  
First Time

Abstract Purpose This study quantitatively evaluated the phasic right heart morphology of candidate patients for a transcatheter tricuspid valve intervention (N=32) and of subjects with trace to no tricuspid regurgitation (N = 14). Methods Cardiac computed tomography angiography (CCTA) and transthoracic/transesophageal echocardiography (TTE/TEE) images were analyzed using dedicated research and clinical software. Using CCTA, the phasic right atrial and ventricular volumes, annulus dimensions, annulus-to-right coronary artery (RCA) distances, circumferential topography of the annular tissue shelf, vena cava dimensions (inferior and superior), vena cava positions, axis angles, and annular excursions were quantified. Using TTE/TEE, leaflet geometry, regurgitation, hemodynamics, and heart function were quantified. Measurements within and between groups were quantitatively compared with regression analyses to explore relationships between right heart features. Results The phasic position and orientation of the vena cava and the circumferential topography of the annular tissue shelf were quantitatively presented for the first time. The candidate patient group exhibited greater chamber dimensions, enlarged vena cava, distended vena cava positions, positional shallowing of the annular tissue shelf, geometric annular distortion, leaflet distention, moderate or greater regurgitation, and impaired ventricular function. Atrial volume correlated strongly with directional vena cava positions as well as with annular dimensions. Annulus-to-RCA distances and annular excursions were comparable between groups. Conclusions This study provides new and further insight to the right heart morphology and functional characteristics of candidate patients for a transcatheter tricuspid valve intervention. These data provide a platform from which these patients can continue to be better understood for further improving transcatheter system design and use.

Pacemaker lead related severe tricuspid stenosis and a history of severe COVID-19 pneumonia: A case report

2021 ◽  
Author(s):  
Kadriye Memic Sancar ◽  
Gamze Babur Guler ◽  
Enes Arslan ◽  
Ender Oner ◽  
Ekrem Güler ◽  
...  
Keyword(s):  
Case Report ◽  
Inflammatory Response ◽  
Tricuspid Valve ◽  
Rare Complication ◽  
Pacemaker Lead ◽  
Pacemaker Leads ◽  
History Of

Tricuspid stenosis occurs after the implantation of a ventricular pacemaker lead and is a rare complication. An inflammatory response is stimulated when the pacemaker leads are passing through the tricuspid valve which leads to fibrosis in the long-term. In our case report, we aim to present a patient with asymptomatic multiple pacemaker lead related tricuspid stenosis and with a history of severe COVID-19 pneumonia.

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