Figure 2 - available via license: CC BY-NC-ND
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Snare technique: Selective cannulation of the posterior cardiac vein (black arrow). Guidewire advanced through the anterior collateral veins and anastomotic vein directly back to the PLSVC (white arrow). Snare system introduced through a second sheath via the LSV up to the PLSVC (black arrow). LSV: left subclavian vein; PLSVC: persistence of the left superior vena cava.
Source publication
Persistence of the left superior vena cava occurs in about 0.3-0.7% of the general population. It is of particular importance in patients who need cardiac resynchronisation therapy. We present a unique case in which a snare system and tunnelling tool were used to place the left ventricular lead in a patient with persistence of the left superior ven...
Citations
... 16 Utilization of the snare technique in patients undergoing LV lead placement in the presence of a PLSVC has not been widely reported. 17 Our case lends further support to the use of this approach to assist in the placement of the LV lead in patients with anatomical variants, such as a PLSVC. ...
Left ventricular lead positioning is technically demanding in cardiac resynchronization therapy (CRT) device implantation, especially in patients with complex cardiac venous anatomies. We report a case in which retrograde snaring was employed to successfully deliver the left ventricular lead through a persistent left superior vena cava for CRT implantation.
