Key result
Epigastric venotomy enables successful permanent pacemaker implantation in a patient lacking an SVC.
Case Report (n=1)
In patients with absent superior vena cava, permanent pacemaker implantation can be successfully achieved via the epigastric and external iliac veins.
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May enable endocardial pacing via epigastric-external iliac route in SVC absence; leaves open broader applicability pending additional cases.
Endocardial pacemaker electrode implantation can be difficult in patients with anomalous superior vena cava (SVC). Venography and CAT scan showed that the patient lacked SVC venous drainage and that systemic veins drained into the inferior vena cava through the azygos vein. A temporary stimulation electrode was placed by puncture of the femoral vein, permanent stimulation by venotomy of the epigastric vein, with the electrode inserted through the external iliac vein.
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Ojo et al. (1999) conducted a case report in Absence of superior vena cava requiring pacemaker implantation (n=1). Pacemaker implantation via femoral and epigastric veins was evaluated on Successful pacemaker implantation. Permanent pacemaker stimulation was successfully achieved via venotomy of the epigastric vein with the electrode inserted through the external iliac vein in a patient lacking a superior vena cava.
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