Normal view MARC view ISBD view

The combination of coronary sinus ostial atresia/abnormality and a small persistent left superior vena cava-Opportunity for left ventricular lead implantation and unrecognized source of thromboembolic stroke.

MedStar author(s):

Citation: Heart Rhythm. 2021 May 08PMID: 33971333Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021 Local holdings: Available online through MWHC library: 2004 - presentISSN:

1547-5271

Name of journal: Heart rhythmAbstract: BACKGROUND: Coronary sinus (CS) ostial atresia/anomalies prevent access to the CS from the right atrium (RA) for left ventricular (LV) lead implantation. Some patients with CS ostial anomalies also have a small persistent left superior vena cava (sPLSVC).CONCLUSION: When CS ostial anomalies prevent access to the CS from the RA, sPLSVC can be used to successfully implant LV leads. In some, the CS partially drains into the LA and stroke can occur spontaneously or during lead intervention. It is important to distinguish sPLSVC associated with CS ostial anomalies from isolated PLSVC. Copyright (c) 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.METHODS: Twenty patients with CS ostial anomalies and sPLSVC were identified. Clinical information, imaging methods, LV lead implantation techniques, and complications were summarized.OBJECTIVE: The purpose of this study was to describe CS ostial anomalies and sPLSVC as an opportunity for LV lead implantation and unrecognized source of stroke.RESULTS: Forty percent had at least 1 previously unsuccessful LV lead placement. In 70%, sPLSVC was identified by catheter manipulation and contrast injection in the left brachiocephalic vein, and in 30% by levophase CS venography. In 30%, sPLSVC was associated with drainage from the CS into the left atrium (LA). When associated with CS ostial anomalies, the sPLSVC diameter averaged 5.6 +/- 3 mm. sPLSVC was used for successful LV lead implantation in 90% of cases. In 80%, the LV lead was implanted down sPLSVC, and in 20%, sPLSVC was used to access the CS from the RA. Presumably because of unrecognized drainage from the CS to the LA, 1 patient had a stroke during implantation via sPLSVC.All authors: Candemir B, Hadadi CA, Kanjwal K, Kaufman M, Kushnir A, McKillop M, Mouram S, Nair D, O'Donoghue S, Padala S, Sellers M, Steen T, Strouse D, Thomaides A, Worley SJ, Zou FFiscal year: FY2021 Digital Object Identifier:

https://dx.doi.org/10.1016/j.hrthm.2021.05.004

Date added to catalog: 2021-06-28

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33971333	Available		33971333

Available online through MWHC library: 2004 - present

BACKGROUND: Coronary sinus (CS) ostial atresia/anomalies prevent access to the CS from the right atrium (RA) for left ventricular (LV) lead implantation. Some patients with CS ostial anomalies also have a small persistent left superior vena cava (sPLSVC).

CONCLUSION: When CS ostial anomalies prevent access to the CS from the RA, sPLSVC can be used to successfully implant LV leads. In some, the CS partially drains into the LA and stroke can occur spontaneously or during lead intervention. It is important to distinguish sPLSVC associated with CS ostial anomalies from isolated PLSVC. Copyright (c) 2021 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

METHODS: Twenty patients with CS ostial anomalies and sPLSVC were identified. Clinical information, imaging methods, LV lead implantation techniques, and complications were summarized.

OBJECTIVE: The purpose of this study was to describe CS ostial anomalies and sPLSVC as an opportunity for LV lead implantation and unrecognized source of stroke.

RESULTS: Forty percent had at least 1 previously unsuccessful LV lead placement. In 70%, sPLSVC was identified by catheter manipulation and contrast injection in the left brachiocephalic vein, and in 30% by levophase CS venography. In 30%, sPLSVC was associated with drainage from the CS into the left atrium (LA). When associated with CS ostial anomalies, the sPLSVC diameter averaged 5.6 +/- 3 mm. sPLSVC was used for successful LV lead implantation in 90% of cases. In 80%, the LV lead was implanted down sPLSVC, and in 20%, sPLSVC was used to access the CS from the RA. Presumably because of unrecognized drainage from the CS to the LA, 1 patient had a stroke during implantation via sPLSVC.

English