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.

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 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.

Single-Patch Fold-Back Technique for Augmentation of the Superior Vena Cava in Sinus Venosus Atrial Septal Defect Associated with Partial Anomalous Pulmonary Venous Return

2015 ◽  
Vol 17 (6) ◽  
pp. 282
Author(s):  
Suguru Ohira ◽  
Kiyoshi Doi ◽  
Takeshi Nakamura ◽  
Hitoshi Yaku
Keyword(s):  
Atrial Septal Defect ◽  
Superior Vena Cava ◽  
Septal Defect ◽  
Venous Return ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Sinus Venosus ◽  
Right Atrial ◽  
Anomalous Pulmonary Venous Return

Sinus venosus atrial septal defect (ASD) is usually associated with partial anomalous pulmonary venous return (PAPVR) of the right pulmonary veins to the superior vena cava (SVC), or to the SVC-right atrial junction. Standard procedure for repair of this defect is a patch roofing of the sinus venosus ASD and rerouting of pulmonary veins. However, the presence of SVC stenosis is a complication of this technique, and SVC augmentation is necessary in some cases. We present a simple technique for concomitant closure of sinus venosus ASD associated with PAPVR and augmentation of the SVC with a single autologous pericardial patch.

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

scholarly journals Recurrent cardiac hydatid cyst located near the root of the superior vena cava and the interatrial septum: a case report

2022 ◽  
pp. 1-4
Author(s):  
Redha Lakehal ◽  
Farid Aymer ◽  
Soumaya Bendjaballah ◽  
Rabah Daoud ◽  
Khaled Khacha ◽  
...  
Keyword(s):  
Hydatid Cyst ◽  
Facial Paralysis ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Vena Cava ◽  
Lower Lobe ◽  
Lateral Wall ◽  
Right Atrial ◽  
Risk Of Rupture ◽  
The Right

Introduction: Cardiac localization of hydatid disease is rare (<3%) even in endemic countries. Affection characterized by a long functional tolerance and a large clinical and paraclinical polymorphism. Serious cardiac hydatitosis because of the risk of rupture requiring urgent surgery. The diagnosis is based on serology and echocardiography. The aim of this work is to show a case of recurrent cardiac hydatid cyst discovered incidentally during a facial paralysis assessment. Methods: We report the observation of a 26-year-old woman operated on in 2012 for pericardial hydatid cyst presenting a cardiac hydatid cyst located near the abutment of the SCV discovered incidentally during an exploration for left facial paralysis: NYHA stage II dyspnea. Chest x-ray: CTI at 0.48. ECG: RSR. Echocardiography: Image of cystic appearance at the level of the abutment of the SVC. SAPP: 38 mmhg, EF: 65%. Thoracic scan: 30/27 mm cardiac hydatid cyst bulging the lateral wall of the right atrium and the trunk of the right pulmonary artery with fissured cardiac hydatid cyst of the apical segment of the right lung of the right lower lobe with multiple bilateral intra parenchymal and sub pleural nodules. The patient was operated on under CPB. Intraoperative exploration: Presence of a hard and whitish mass, about 03 / 03cm developed in the full right atrial wall opposite the entrance to the superior vena cava. Procedure: Resection of the mass removing the roof of the LA, the AIS and the wall of the RA with reconstruction of the roof of the RA by patch in Dacron and reconstruction of the IAS and the wall of the RA by a single patch in Dacron. Results: The postoperative suites were simple. Conclusion: The hydatid cyst is still a real endemic in Algeria, the cardiac location is rare but serious and can constitute a real surgical emergency, hence the importance of prevention. Keywords: Hydatid cyst of the heart; Recurrence; Surgery; Cardiopulmonary Bypass; Prevention

scholarly journals Incidental Detection of Persistent Left Superior Vena Cava during Transvenous Pacing

2015 ◽  
Vol 3 (2) ◽  
pp. 52-54
Author(s):  
S Subash ◽  
Divya Gopal ◽  
Ashwini Thimmarayappa
Keyword(s):  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Pacemaker Implantation ◽  
Vena Cava ◽  
Venous Access ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena ◽  
Pacing Lead ◽  
Chest X Ray

ABSTRACT Patients with persistent left superior vena cava (PLSVC) are usually asymptomatic, but due to its anatomical defects, difficulties in establishing central venous access, pacemaker implantation and cardiothoracic surgery are common. We report a case of 65 years old patient who presented with complete heart block in cardiac critical care and, after emergency transvenous pacing, the chest X-ray showed unusual course of the transvenous pacing lead, which on further transthoracic echocardiographic (TTE) evaluation demonstrated dilated coronary sinus with PLSVC. How to cite this article Subash S, Gopal D, Thimmarayappa A. Incidental Detection of Persistent Left Superior Vena Cava during Transvenous Pacing. J Perioper Echocardiogr 2015; 3(2):52-54.

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