Uspešna ugradnja resinhronizaciono-defibrilatorskog aparata preko perzistentne leve gornje šuplje vene

  • Mihailo Čedomir Vukmirović Center of Cardiology, Clinical Center of Montenegro, Podgorica, Montenegro
  • Lazar Angelkov Institute of Cardiovascular Disease “Dedinje”, Belgrade, Serbia
  • Filip Vukmirović Center of Patology, Clinical Center of Montenegro, Podgorica, Montenegro
  • Irena Tomašević Vukmirović Center of Radiology, Clinical Center of Montenegro, Podgorica, Montenegro
DOI: https://doi.org/10.2298/2103
Ključne reči: vena cava superior||, ||v. cave superior, vascular malformations||, ||krvni sudovi, malformacije, cardiac pacing artificiall||, ||srce, veštačko usklađivanje ritma, defibrilator implantable||, ||defibrilator, implantabilni, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Leva gornja šuplja vena je najčešća anomalija vena toraksa koja je uglavnom asimptomatska. Obično se verifikuje prilikom ugradnje pejsmejkera kada može jako otežati, a nekada i potpuno onemogućiti postavljanje elektroda. Problem koji nastaje zbog anomalije venskog sistema je u odgovarajućem pozicioniranju elektroda, odnosno u njihovoj stabilnosti. Prikaz bolesnika. Prikazali smo uspešnu implantaciju resinhronizacionog defibrilatorskog aparata (CRT-D) kod bolesnika starog 55 godina, sa dilatativnom kardiomiopatijom, odnosno teškom srčanom slabošću, kojem je u toku intervencije detektovana perzistentna leva gornja šuplja vena. Uprkos anomaliji venskog sistema toraksa, uspeli smo da pozicioniramo elektrodu u izlazni trakt desne komore, posteriornu granu koronarnog sinusa, odnosno u desnu pretkomoru. Zaključak. Urođene anomalije vena toraksa mogu jako da otežaju postavljanje elektroda na adekvatnu, odnosno stabilnu poziciju. Ipak, pokazali smo da se i kod ovakvih bolesnika može uspešno ugraditi resinhronizacioni defibrilator.

 

 

Biografija autora

Mihailo Čedomir Vukmirović, Center of Cardiology, Clinical Center of Montenegro, Podgorica, Montenegro

internista kardiolog

magistar kardiologije

Reference

Fry AC, Warwicker P. Bilateral superior vena cava. N Engl J Med 2007; 356: 18.

Peltier J, Destrieux C, Desme J, Renard C, Remond A, Velut S. The persistent left superior vena cava: anatomical study, pathogenesis and clinical considerations. Surg Radiol Anat 2006; 28(2): 206−10.

Schreve-Steensma AM, Van der Valk PH, Ten Kate JB, Kofflard MJ. Discovery of a persistent left superior vena cava during pacemaker implantation. Neth Heart J 2008; 16(7−8): 272–4.

Tak T, Crouch E, Drake GB. Persistent left superior vena cava: incidence, significance and clinical correlates. Int J Card 2002; 82(1): 91−3.

Jović Z, Mijailović Z, Obradović S, Tavčiovski D, Matunović R, Rusović S. Successful implantation of a permanent pacemaker through a persistent left superior vena cava by using a right subclavian approach. Vojnosanitetski pregled 2011; 68(9): 792−4.

Reinhardt D, Surber R, Kuehnert H, Heinke M, Figulla HR. Implantation of a re- synchronization device in a patient with persistent left superior vena cava-a case report. Indian Heart J 2010; 62(4): 344−5.

Antonelli D, Freedberg M, Feldman A. Implantation of a Resynchronization Implantable Cardioverter Defibrillator in a Patient with Persistent Left Superior Vena Cava. Indian Pacing Electrophysiol J 2007; 7(4): 246−8.

Lappegard KT, Prytz JF, Haug B. Pacemaker implantation in patients with persistent left superior vena cava. Heart Vessels 2004; 19(3): 153−4.

Smyth YM, Barrett CD, Fahy GJ. Biventricular pacemaker implant in a patient with persistent left sided superior vena cava. Heart 2005; 91(11): 1427.

Gasparini M, Mantica M, Galimberti P, Coltorti F, Simonini S, Ceriotti C, et al. Biventricular pacing via a persistent left superior vena cava: report of four cases. Pacing Clin Electrophysiol 2003; 26(1): 192−6.

Biffi M, Boriani G, Frabetti L, Bronzetti G, Branzi A. Left superior vena cava persistence in patients undergoing pacemaker or cardioverter-defibrillator implantation: a 10-year experience. Chest 2001; 120(1): 139−44.

Srimannarayana J, Sekhlar Varma R, Satheesh S, Anilkumar R, Balachander J. Transvenous permanent pacemaker implantation through persistent left superior vena cava. Indian Heart J 2004; 56(4): 346−8.

Konstantino Y, Kusniec J, Shohat-Zabarski R, Battler A, Strasberg B. Cardiac defibrillator implantation via persistent left superior vena cava facilitated by a coronary sinus delivery system. Europace 2009; 11(1): 119−20.

Rogers D, Walker F, Chow F, Lambiase PD. Biventricular Device Implantation in a Patient with Congenitally Corrected Transposition and Left-Sided Superior Vena Cava. Pacing Clin Electrophysiol 2008; 31(4): 499−502.

Kapetanopoulos A, Peckham G, Kiernan F, Clyne C, Kluger J, Migeed MA. Implantation of a biventricular pacing and defibrillator device via a persistent left superior vena cava. J Cardiovasc Med (Hagerstown) 2006; 7(6): 430−3.

Objavljeno
2017/01/20
Broj časopisa
Vol. 70 Br. 12 (2013)
Rubrika
Prikaz bolesnika