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Chronic Lung Collapse: A Predictable Impediment to Ipsilateral Lead Placement
Author(s) -
III F. EARL FYKE
Publication year - 1989
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1989.tb01906.x
Subject(s) - medicine , lead (geology) , lung , deformity , surgery , permanent pacemaker , geomorphology , geology
Implantation of a permanent transvenous pacemaker was undertaken in a patient with longstanding, complete collapse of the right lung. Unanticipated distortion of the lead path prevented entirely introduction of a right subclavian sheath and rendered lead placement from a right cephalic venotomy extremely difficult An angioplasty guidewire substituted for the standard stylets proved useful in positioning the lead. This report describes the predictable venous deformity, illustrates the consequent impediment to ipsilateral lead placement, and discusses why contralateral entry sites should be superior in cases of massive loss of lung volume.