Veia cava superior esquerda persistente – Um acesso vascular sem limitações

Persistent left superior vena cava (PLSVC) is the most common thoracic congenital malformation and its diagnosis usually occurs by chance. Demonstrative clinical cases of dual-chamber (DDD) pacemaker implantation, implantable cardioverter defibrillators and cardiac resynchronization systems through PLSVC access have already been described in the literature. However, in most of the cases presented, the positioning of the lead in the right ventricle (RV) was restricted to the RV apex. To date, the literature reports only four cases of RV lead positioning in the right ventricular outflow tract (RVOT) via the PLSVC. The authors present the case of a 79-year-old female patient, diagnosed with syncope and left branch bundle block, in whom implantation of a DDD pacemaker was proposed. During the procedure, venous access was obtained via the left cephalic vein, and the lead was found to progress to the left of the spinal column, suggesting the presence of PLSVC. Through this access,