Sundhu Murtaza, Syed Mubbasher, Gul Sajjad, Saqi Bilal, Mosteller Robert
Internal Medicine Residency, Fairview Hospital, Cleveland Clinic, USA.
Electrophysiology, Fairview Hospital, Cleveland Clinic, USA.
Cureus. 2017 Jun 5;9(6):e1311. doi: 10.7759/cureus.1311.
Persistent left superior vena cava (PLSVC) is a rare disorder which is asymptomatic and hence is usually discovered while performing interventions through the left subclavian vein. We present a case of a 78-year-old male who was undergoing elective placement of a permanent pacemaker for tachycardia - bradycardia syndrome with post-conversion pauses of up to nine seconds. After achieving access through the left subclavian vein the wire kept on going on the left side of the chest instead of crossing the midline to the right side. The wire was removed and contrast venography was done, PLSVC with dilated coronary sinus emptying into the right atrium was confirmed. There was some difficulty in passing the lead to the right ventricle even with the acute curve in the stylet. The sheath size was increased and a longer deflectable sheath was used and with the tip of the lead anteriorly the right ventricle was cannulated and the lead was affixed. There were good sensing and pacing parameters. Post procedure chest x-ray was done and the patient was discharged without any complications.
永存左上腔静脉（PLSVC）是一种罕见的疾病，通常无症状，因此常在通过左锁骨下静脉进行干预操作时被发现。我们报告一例78岁男性患者，该患者因心动过速-心动过缓综合征且转复后停搏长达9秒，正在接受择期永久性起搏器植入术。在通过左锁骨下静脉建立通路后，导线一直沿胸部左侧走行，而未穿过中线至右侧。导线被移除并进行了静脉造影，证实为永存左上腔静脉伴扩张的冠状窦汇入右心房。即使在探针带有急性弯曲的情况下，将导线送入右心室仍存在一些困难。增大了鞘管尺寸并使用了更长的可弯曲鞘管，将导线尖端向前，成功插入右心室并固定导线。感知和起搏参数良好。术后进行了胸部X线检查，患者出院时无任何并发症。
