Key result
Cyanoacrylate glue occlusion successfully seals coronary sinus perforation during CRT implantation, preserving long-term lead function.
Why the study?
Coronary sinus venous branch stenosis is uncommon and balloon dilatation of venous tributaries may carry risks of perforation.
Does glue (n-butyl-2-cyanoacrylate) occlusion safely and effectively manage coronary sinus venous perforation during left ventricular lead implantation?
Case Report (n=1)
Does glue (n-butyl-2-cyanoacrylate) occlusion safely and effectively manage coronary sinus venous perforation during left ventricular lead implantation?
Local glue injection represents a viable and effective endovascular strategy for managing coronary sinus venous perforations without compromising the long-term functionality of implanted LV leads.
Answers are grounded in this paper and cite their sources.
May offer bailout for coronary sinus perforation during CRT; leaves open need for prospective validation.
Background Coronary sinus venous branch stenosis is an uncommon entity. Balloon dilatation of venous tributary may not always be safe. We report a case of venous perforation following balloon dilatation, which was managed by glue occlusion and completion of cardiac resynchronization therapy (CRT) implantation. Case summary A 50-year-old man was diagnosed with non-ischaemic cardiomyopathy with New York Heart Association (NYHA) Class III dyspnoea despite optimal medical therapy. The electrocardiogram showed a left bundle branch block with a QRS duration of 168 ms, and 2D echocardiography revealed dilated cardiomyopathy with a left ventricular ejection fraction of 20%. The patient was taken for CRT implantation; however, there was severe stenosis in the posterolateral vein noted during left ventricular (LV) lead implantation, hindering LV lead advancement. Following balloon dilatation, there was perforation of the vein with hypotension. The perforation was sealed with glue injection (n-butyl-2-cyanoacrylate), and LV lead placement was performed. At the 4-year follow-up, the patient is in NYHA Class I and the ejection fraction improved to 60%, with an excellent LV threshold and good synchronization. Discussion Glue (n-butyl-2-cyanoacrylate) occlusion can manage coronary sinus perforation with suitable long-term LV lead parameters.
No takes yet. Share an insight, caveat, or question.
Gupta et al. (2025) conducted a case report in coronary sinus venous perforation during left ventricular lead implantation (n=1). Glue (n-butyl-2-cyanoacrylate) occlusion was evaluated on Successful sealing of venous perforation and completion of CRT implantation. Glue (n-butyl-2-cyanoacrylate) occlusion successfully sealed a coronary sinus venous perforation during CRT implantation, allowing for stable long-term left ventricular lead parameters and clinical improvement over 4 years of follow-up.
Synapse has enriched 10 related papers. Consider them for comparative context: