Chest
Clinical InvestigationsCardiologyLeft Superior Vena Cava Persistence in Patients Undergoing Pacemaker or Cardioverter-Defibrillator Implantation: A 10-Year Experience
Section snippets
Materials and Methods
The study was prospectively conducted from October 1989 to September 1999 on all patients undergoing PM implantation; from January 1992 to September 1999, patients undergoing transvenous CD implantation were also taken into consideration. Patients with congenital thoracic-abdominal abnormalities were not considered due to the likelihood of associated LSVC persistence5,6,7,8; this would have increased the prevalence in the patients with bradyarrhythmias and tachyarrhythmias. Patients requiring
Results
During 10 years, 1,147 consecutive patients without congenital abnormalities underwent PM implantation for commonly accepted indications; 8 patients were occasionally discovered to have asymptomatic left subclavian thrombosis (angiographically documented during implantation) and were hence excluded from analysis due to the impossibility of ruling out LSVC persistence. Of the other 1,139 patients, 627 patients were male (55%) and 512 were female (45%); 4 of 1,139 patients had patency of LSVC
Discussion
Persistence of LSVC in adult life is normal in rabbits and some other mammals, but it is a rare abnormality in man. Besides being associated with congenital diseases,5,6,7,8 its most relevant clinical implication is the association with disturbances of cardiac impulse formation and conduction.20 The ontogenetic development of the sinus node, the AV node, and the His bundle may be heavily influenced by the lack of regression of the left cardinal vein,21,22,23 since these structures are located
References (30)
- et al.
Persistent left superior vena cava draining into the left atrium without arterial oxygen unsaturation
Am J Cardiol
(1965) - et al.
Persistent left superior vena cava, fibrous remnant of the right superior vena cava and ventricular septal defect
Am J Cardiol
(1964) - et al.
Persistent left superior vena cava complicating pacemaker insertion
Chest
(1972) - et al.
Implication of a persistent left superior vena cava in transvenous pacemaker therapy and cardiac hemodynamic monitoring
Chest
(1974) - et al.
An absent right and persistent left superior vena cava in an infant requiring extracorporeal membrane oxygenation
J Pediatr Surg
(1993) - et al.
Transvenous cardioverter-defibrillator implantation via persistent left superior vena cava
Am Heart J
(1995) Cardiac conduction system: fetal and postnatal development
Am J Cardiol
(1970)- et al.
Two cases of congenital asplenia with isomerism of the cardiac atria and the sinoatrial nodes
Am J Cardiol
(1964) The development of the human pulmonary vein and the coronary sinus in the human embryo [thesis]
(1958)Embryology of the heart