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. 2013 Apr;4(2):64-67.
doi: 10.4021/cr267w. Epub 2013 May 9.

Persistent Left Superior Vena Cava in Patients Undergoing Cardiac Device Implantation: Clinical and Long-Term Data

Dubravko Petrac  1 , Vjekoslav Radeljic  1 , Nikola Pavlovic  1 , Sime Manola  1 , Diana Delic-Brkljacic  1
Affiliations

Persistent Left Superior Vena Cava in Patients Undergoing Cardiac Device Implantation: Clinical and Long-Term Data

Dubravko Petrac et al. Cardiol Res. 2013 Apr.

Abstract

Background: Persistent left superior vena cava (LSVC) is a rare congenital venous anomaly that may be found at the time of cardiac device lead insertion.

Methods: In this case series, we present clinical and long-term data of five patients with LSVC who underwent pacemaker (PM) or cardioverter defibrillator (ICD) implantation during the period of 10 years.

Results: Left-sided venous approach was used for device implantation in 3 patients with standard PM indications, whereas a right-sided venous approach and an epicardial approach had to be used in 2 patients who needed an ICD and biventricular PM, respectively. In post implantation period of 44 ± 29 months, one patient died due to stroke, one underwent heart transplantation, and 3 had atrial fibrillation.

Conclusion: The long-term outcome of patients with persistent LSVC and implanted cardiac devices is mostly influenced by the presence of underlying heart disease.

Keywords: Cardiac device implantation; Long-term outcome; Persistent left superior vena cava.

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Figures

Figure 1
Figure 1
Digital substraction angiography of the upper venous system in patients with a right atrial pacing. Persistent left vena cava superior drains through the coronary sinus to the right atrium and serves as a truck for the atrial lead placement (patient 1).
Figure 2
Figure 2
A) Multislice CT-angiography showing a persistent left superior vena cava with a presentation of right subclavian vein. B) A quadripolar dual coil active defibrillation lead was inserted in the right ventricle via right subclavian vein and connected with an ICD impalanted at right pectoral side (patient 3).
See this image and copyright information in PMC

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