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Massive Thrombosis of the Coronary Sinus As an Unusual Complication of Transvenous Pacemaker Insertion in a Patient with Persistent Left, and No Right Superior Vena Cava
Author(s) -
CHAITHIRAPHAN SUPHACHAI,
GOLDBERG EMANUEL,
WOLFF WILLIAM,
JOOTAR PAYONK,
GROSSMAN WILL
Publication year - 1974
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1974.tb06274.x
Subject(s) - medicine , persistent left superior vena cava , coronary sinus , asymptomatic , surgery , superior vena cava , thrombosis , complication , transvenous pacing , venous return curve , cardiac catheterization , cardiology , hemodynamics
Persistent left superior vena cava associated with lack of a right superior vena cava constitutes a rare anomalous pathway of venous return to the heart; drainage is usually into the coronary sinus. The patients often are asymptomatic and the anomaly is detected only accidentally during catheterization of the right heart. The patient reported here (an 85‐year‐old man) had the foregoing abnormal form of venous return, which presented great difficulty when insertion of a transvenous pacemaker was attempted. Subsequently the patient died from bronchopneumonia, and postmortem examination revealed massive thrombosis of the coronary sinus. This may be the first report of such a complication of intravenous pacemaker implantation. Complete occlusion of the coronary sinus in this situation may prevent venous return from the upper part of the body. The literature is reviewed and recommendations are made for alternative management of this unusual problem.