Cardiac Resynchronization Therapy in Patients with Absent Right but Persistent Left Superior Vena Cava

Abstract

Abnormalities of the vena cava system are usually asymptomatic and are found incidentally during pacemaker implantation or catherization. We report a case of dilative cardiomyopathy requiring cardiac resynchronization defibrillator therapy (CRT‐D). During the operation, a persistent left superior vena cava with an absent right vena cava was discovered. During open chest surgery, we implanted a CRT‐D with epicardial patches and pacing leads, which is a simple technique for safe and reliable biventricular defibrillator therapy in these patients.

Key words

Cardiomyopathy - cardiac resynchronization - persistent left SVC - defibrillator - pacemaker

References

• 1 Campbell M, Deuchar D C. The left-sided superior vena cava.  Br Heart Journal. 1954;  16 423-439
• 2 Lenox C C, Hashida Y, Anderson R H, Hubbard J D. Conduction tissue anomalies in absence of the right superior caval vein.  Int J Cardiol. 1985;  8 251-260
• 3 Moss A, Zareba W, Hall W, Klein H, Wilber D J, Cannom D S, Daubert J P, Higgins S L, Brown M W, Andrews M L. Multicenter Automatic Defibrillator Implantation Trial II Investigators . Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.  N Engl J Med. 2002;  346 877-883
• 4 Favale S, Bardy G H, Pitzalis M V, Dicandia C D, Traversa M, Rizzon P. Transvenous defibrillator in patients with persistent left superior vena cava and right superior vena cava atresia.  Eur Heart J. 1995;  16 704-707
• 5 Rusk R A, Bexton R S, McComb J M. Persistent left sided and absent right sided superior vena cava complicating permanent pacemaker insertion.  Heart. 1996;  75 413