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A 69-year-old man with ischemic heart disease presented with increasing lethargy and breathlessness several months after coronary artery bypass surgery. In the immediate postoperative period, he developed heart block requiring insertion of a pacemaker; during the procedure, however, there was excessive bleeding from the right subclavian vein puncture site, and only a single-chamber pacemaker could be inserted. This was upgraded to a 3-lead system via a further right subclavian venous puncture 4 months later. One month after this procedure, a loud continuous murmur became audible …

Endovascular Management of an Innominate-Caval Fistula Secondary to Insertion of a Cardiac Pacemaker