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Coronary Vein Rupture during Venoplasty for LV Lead Placement
Author(s) -
WORLEY SETH J.,
GOHN DOUGLAS C.,
PULLIAM ROBERT W.
Publication year - 2008
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.1540-8159.2008.01108.x
Subject(s) - medicine , coronary vein , cardiac resynchronization therapy , pericardium , balloon , cardiology , stenosis , limiting , complication , vein , surgery , lead (geology) , radiology , heart failure , coronary sinus , ejection fraction , mechanical engineering , geomorphology , geology , engineering
Coronary vein rupture is a potential complication of venoplasty for LV lead placement. Vein rupture in a patient with a virgin pericardium would be anticipated to have a profound hemodynamic impact from bleeding into the pericardial space. This report describes an elderly woman with a virgin pericardial space who underwent cardiac resynchronization therapy (CRT). Venoplasty of a lead limiting venous stenosis was performed on the lateral coronary vein. The stenosis was unresponsive to a standard noncompliant balloon with side wire. When the inflation pressure was increased beyond the rated burst pressure the balloon ruptured, perforating the vein. We describe our experience in successfully placing the left ventricular lead safely despite the problems arising from these circumstances.