A case report of balloon-assisted tracking to overcome coronary sinus competent valve: a novel technique in left ventricular lead implantation. Issue 2 (2nd February 2022)

• Record Type: Journal Article
• Authors: Samy, Mohamed; Hamdy, Rehab M
• Editors: Arroyo, Ruben Casado; Duncker, David; Enache, Bogdan; Ngo, Linh; Chakir, Mariame
• Is Part Of: European heart journal. Volume 6:Issue 2(2022)
• Publication Date: 2022-02-02
• Subjects: Cardiac resynchronization therapy -- Coronary sinus valves -- Balloon-assisted tracking -- Dilated cardiomyopathy -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytac056
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Competent lateral and posterolateral valves showed proximal tortuosity that might hinder left ventricular (LV) lead implantation in cardiac resynchronization therapy (CRT). Case summary: A 57-year-old woman was diagnosed as non-ischaemic cardiomyopathy, no other comorbidities, complaining of dyspnoea [New York Heart Association (NYHA) class III], and on optimal medical therapy. Electrocardiogram showed left bundle branch block with QRS duration 150 ms. The patient was candidate for CRT. However, during LV lead implantation, a competent posterolateral vein valve and proximal tortuosity hindered LV lead implantation that was overcome by balloon-assisted tracking technique. At 9 months of follow-up, the patient had NYHA class II, ejection fraction improved to 38%, and all implanted leads were still in place. Discussion: Balloon-assisted tracking technique can be used to cross coronary sinus and smaller veins with competent valves and coronary veins tortuosity.