Key result
Left ventricular lead placement was successfully and safely completed despite coronary vein rupture caused by balloon rupture during venoplasty in an elderly woman.
Case Report (n=1)
This case report demonstrates that successful LV lead placement is possible even after coronary vein rupture during venoplasty in a patient with a virgin pericardium.
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Supports proceeding with LV lead placement after venoplasty rupture in select cases; leaves open generalizability beyond this report.
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.
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Worley et al. (2008) conducted a case report in Coronary vein rupture during venoplasty (n=1). Venoplasty for LV lead placement was evaluated on Successful placement of the left ventricular lead. Left ventricular lead placement was successfully and safely completed despite coronary vein rupture caused by balloon rupture during venoplasty in an elderly woman.
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