Key result
A collateral approach using a large branch of the middle cardiac vein provides an alternative route for left ventricular lead placement following complete proximal coronary sinus obstruction.
The 'collateral approach' using a branch of the middle cardiac vein can serve as a viable alternative route for LV lead placement when the proximal coronary sinus is obstructed during resynchronization therapy.
The finding of complete obstruction of the proximal coronary sinus after left ventricular (LV) lead extraction during LV lead replacement is uncommon. In our case, we used a large collateral branch of the middle cardiac vein as an alternative route to the postero-lateral region. We have termed this the 'collateral approach'.
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Willem G. de Voogt (2006) studied this question. A collateral approach using a large branch of the middle cardiac vein provides an alternative route for left ventricular lead placement following complete proximal coronary sinus obstruction.
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