CASE REPORT
Cardiovascular Surgery
doi: 10.25005/2074-0581-2024-26-1-152-160
PACEMAKER IMPLANTATION IN A PATIENT WITH UPPER LIMB VENOUS OBSTRUCTION: A CASE REPORT

V.O. POVAROV, R.E. KALININ, N.D. MZHAVANADZE, I.A. SUCHKOV

Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University named after Academician I.P. Pavlov, Ryazan, Russian Federation

Today, permanent cardiac pacing is the most effective way to correct bradyarrhythmia. Most pacemaker leads are implanted through the veins of the upper extremities. Common vein access involves either a cephalic vein cutdown or a puncture of the subclavian or axillary veins. Implantation of leads may become technically difficult or unfeasible if there is an anomaly in the structure of the veins or, more often, occlusion/stenosis of the veins of the upper extremities after thrombosis. The article presents It is illustrated with the case of a 75-year-old patient with indications for pacemaker implantation presented by the article. The first implantation attempt was unsuccessful: extensive occlusion of the left subclavian vein (SCV) and stenosis of the right SCV were detected. The venous obstruction was asymptomatic. The patient underwent venography and was diagnosed with up to 90% luminal narrowing of the right SCV. Percutaneous transluminal angioplasty of the right SCV was performed; the residual stenosis was 50%. Subsequently, a dual-chamber pacemaker was successfully implanted into the patient; the postoperative period was uneventful. The vein obstruction ould be related to a history of malignant neoplasm of the uterus. A brief literature review of various types of vascular access for pacemaker implantation and alternative implantation options complements the case report.

Keywords: Pacemaker, venous thromboembolic complications, deep vein thrombosis, deep vein stenosis, angioplasty.

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Authors' information:

Povarov Vladislav Olegovich
Candidate of Medical Sciences, Assistant of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: P-2383-2017
Scopus ID: 57201192573
ORCID ID: 0000-0001-8810-9518
SPIN: 2873-1391
Author ID: 1016478
E-mail: povarov.vladislav@mail.ru

Kalinin Roman Evgenievich
Doctor of Medical Sciences, Full Professor, Head of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: M-1554-2016
Scopus ID: 24331764400
ORCID ID: 0000-0002-0817-9573
SPIN: 5009-2318
Author ID: 528201
E-mail: rzgmu@rzgmu.ru

Mzhavanadze Nina Dzhansugovna
Doctor of Medical Sciences, Associate Professor, Professor of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: M-1732-2016
Scopus ID: 55440268100
ORCID ID: 0000-0001-5437-1112
SPIN: 7757-8854
Author ID: 757843
E-mail: nina_mzhavanadze@mail.ru

Suchkov Igor Aleksandrovich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University named after Academician I.P. Pavlov
Researcher ID: M-1180-2016
Scopus ID: 56001271800
ORCID ID: 0000-0002-1292-5452
SPIN: 6473-8662
Author ID: 446567
E-mail: suchkov_med@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Suchkov Igor Aleksandrovich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Cardiovascular, Endovascular Surgery and Radiology, Ryazan State Medical University named after Academician I.P. Pavlov

390026, Russian Federation, Ryazan, Vysokovoltnaya str., 9

Tel.: +7 (903) 8362417

E-mail: suchkov_med@mail.ru

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