ICD Lead Implantation Into the Middle Cardiac Vein Using a Coronary Sinus Guiding Catheter After Tricuspid Valve Surgery.
Koji Yasumoto, Yasuyuki Egami, Yasuharu Matsunaga-Lee et al.
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Case in brief
A patient with a history of tricuspid valve surgery required implantation of an implantable cardioverter-defibrillator (ICD). Because a transvenous lead crossing the surgically treated valve could worsen valve function, the team used a coronary sinus guiding catheter to place the ICD lead in the middle cardiac vein. Implantation was successful, providing a lead route that avoided crossing the tricuspid valve.
What made this case unusual
A coronary sinus guiding catheter was used to deliver an ICD lead into the middle cardiac vein after tricuspid valve surgery, avoiding passage of the lead across the operated valve.
Diagnostic / clinical pearl
After tricuspid valve surgery, consider whether an alternative lead route can avoid crossing the valve; this report describes successful ICD lead placement in the middle cardiac vein using a coronary sinus guiding catheter.