Introduction. Persistent left superior vena cava, a rare congenital
abnormality, can complicate placement of pacemaker leads through the
subclavian vein. A left-sided approach is usually preferable in such cases.
Case report. We reported a case in which we began a single-chamber pacemaker
implantation procedure via a right subclavian approach (because of scarring
beneath the left clavicle) and then discovered intraoperatively that the
patient had a persistent left superior vena cava. After a few attempts, we
succeeded in placing the head of the electrode in the septum, near the top of
the right ventricle, and the rest of the procedure was completed without
complication. Conclusion. To our knowledge, this is the first reported case
of pacemaker implantation, with passive electrode, through a persistent left
superior vena cava via the right subclavian vein. This case demonstrates that
such an approach, when necessary, can be used successfully.
Difficulties in attempt of pacemaker implantation in patient with persistent left superior vena cava and agenesis of the right superior vena cava led to diagnosis of Wegener's granulomatosis—three in one rare pathologies: a case report
