Aithal Shodhan, Gupta Anunay, Bansal Sandeep, Isser Hermohander S, Gupta Puneet
Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, IND.
Cureus. 2024 Aug 29;16(8):e68136. doi: 10.7759/cureus.68136. eCollection 2024 Aug.
Persistent left superior vena cava (PLSVC) is a relatively rare anatomical anomaly, with a higher prevalence in those with congenital heart defects. While typically asymptomatic, its presence can complicate certain medical procedures, particularly cardiac interventions, such as the implantation of cardiac resynchronization therapy (CRT) devices, due to acute angulation. In this report, we discuss the challenges posed by the unanticipated presence of PLSVC during CRT device implantation and describe the technique used for lead placement using Judkins Right catheter for support, placing coronary wire, and later placing the left ventricle (LV) lead with the help of buddy wire technique, resulting in successful insertion of all three CRT leads despite the anatomical challenges.
永存左上腔静脉（PLSVC）是一种相对罕见的解剖学异常，在先天性心脏缺陷患者中的患病率较高。虽然通常无症状，但其存在可能会使某些医疗程序复杂化，尤其是心脏介入手术，如心脏再同步治疗（CRT）设备的植入，因为会出现急性成角。在本报告中，我们讨论了CRT设备植入过程中意外出现PLSVC所带来的挑战，并描述了使用右Judkins导管辅助进行导线放置的技术，即先放置冠状动脉导丝，然后借助伙伴导丝技术放置左心室（LV）导线，尽管存在解剖学挑战，但最终成功插入了所有三根CRT导线。
