Objective: The persistence of a left superior vena cava (I,SVC) has been observed in 0.3% of the general population as established by autopsy. In the adult population, it is an important anatomic finding if a left superior approach to the heart is considered. The aim of the study was to evaluate the prevalence of a LSVC in patients undergoing pacemaker (PM) and cardioverter-defibrillator (CD) implantation. Design: We observed the prevalence of LSVC during a 10-year period; each patient undergoing PM or transvenous CD implantation received a left cephalic/left subclavian venous approach to the heart. With this technique, LSVC persistence is easily diagnosed during lead placement. Results: A total of 1,139 patients consecutively underwent PM implantation during 10 years: 4 patients had persistent LSCV (0.34%). Among 115 patients undergoing CD implantation, 2 patients with LSVC (1.7%) were observed, Overall LSVC persistence was found in 6 of 1,254 patients (0.47%), Two patients, one of whom had no light superior vena cava (RSVC), received a left-sided PM, whereas two other patients received right-sided devices. Both CD patients received a left-sided active-can device: the first patient with a right-sided lead tunneled to the left pectoral pocket, as a result of poor catheter handling through the LSVC and coronary sinus, and the second patient with a screw-in lead from]LSVC. Long-term follow-up of these patients (average +/- SD, 41 +/- 26 months) revealed absence of lead dislodgment and appropriate device function regardless of lead implantation site. Conclusions: Persistence of LSVC in adults undergoing PM/CD implantation is similar to that of the general population (0.47% in our study), The left-sided implant can be achieved by stylet shaping and by use of active fixation leads in most patients, with a reliable outcome at short term in addition to appropriate device performance at follow-up. Assessment of the RSVC is advisable when planning a right-sided implantation, since a minority of patients lacks this vessel.
Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience / Biffi, M; Boriani, Giuseppe; Frabetti, L; Bronzetti, G; Branzi, A.. - In: CHEST. - ISSN 0012-3692. - 120:1(2001), pp. 139-144.
|Data di pubblicazione:||2001|
|Titolo:||Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience|
|Autore/i:||Biffi, M; Boriani, Giuseppe; Frabetti, L; Bronzetti, G; Branzi, A.|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1378/chest.120.1.139|
|Codice identificativo ISI:||WOS:000169829900027|
|Codice identificativo Scopus:||2-s2.0-0034890289|
|Codice identificativo Pubmed:||11451829|
|Citazione:||Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience / Biffi, M; Boriani, Giuseppe; Frabetti, L; Bronzetti, G; Branzi, A.. - In: CHEST. - ISSN 0012-3692. - 120:1(2001), pp. 139-144.|
|Tipologia||Articolo su rivista|
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