A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case

Background: The main aim of Cardiac Resynchronization Therapy (CRT) is a positive response of the patient, particularly, reduction of the symptoms and improvement of the heart contractility, that can be reached in 5070% of patients. The possibility of appropriate positioning the left ventricular (LV...

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Autores principales:	Oleg L. Dubrovin, Pavel L. Shugaev
Formato:	article
Lenguaje:	RU
Publicado:	Eco-vector 2021
Materias:	clinical case cardiac resynchronization therapy heart failure Medicine R
Acceso en línea:	https://doaj.org/article/c1819f68684c4abfa4987a2afc4610ea
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id	oai:doaj.org-article:c1819f68684c4abfa4987a2afc4610ea
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spelling	oai:doaj.org-article:c1819f68684c4abfa4987a2afc4610ea2021-11-30T18:15:22ZA successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case2220-30952618-862710.17816/clinpract76720https://doaj.org/article/c1819f68684c4abfa4987a2afc4610ea2021-10-01T00:00:00Zhttps://journals.eco-vector.com/clinpractice/article/viewFile/76720/pdfhttps://doaj.org/toc/2220-3095https://doaj.org/toc/2618-8627Background: The main aim of Cardiac Resynchronization Therapy (CRT) is a positive response of the patient, particularly, reduction of the symptoms and improvement of the heart contractility, that can be reached in 5070% of patients. The possibility of appropriate positioning the left ventricular (LV) lead is of great importance for the response to CRT. Certain instruments and technical approaches are used for the placement of the LV lead. Here, we describe the use of the orthodromic snare technique, which is quite rare in practice, but allows one to overcome some anatomical obstacles. Clinical case description: Patient A., suffering from the heart failure with a low ejection fraction and left bundle branch block, was admitted to the hospital for CRT implantation. Before the operation, all the necessary routine instrumental and laboratory diagnostics was performed. During the operation, venography of the cardiac veins revealed unsuitability of the lateral cardiac vein for the placement of the LV lead due to its very small diameter. The posterolateral vein was suitable for the LV lead implantation but still had some anatomical difficulties: an acute angle of inflow and local stenosis in the proximal segment. During the procedure, the following techniques were used without success: positioning the LV lead by a simple translational movement forward, a subselective catheter, introduction of several coronary guides in order to smooth out the acute angle of inflow. These circumstances warranted the use of the orthodromic snare technique for a successful LV lead placement. Conclusion: This clinical case illustrates the possibility of a safe and effective use of the orthodromic snare technique for LV lead implantation. Such anatomical difficulties as a small diameter, acute angle of inflow, local stenosis have also been illustrated and discussed.Oleg L. DubrovinPavel L. ShugaevEco-vectorarticleclinical casecardiac resynchronization therapyheart failureMedicineRRUКлиническая практика , Vol 12, Iss 3, Pp 112-119 (2021)
institution	DOAJ
collection	DOAJ
language	RU
topic	clinical case cardiac resynchronization therapy heart failure Medicine R
spellingShingle	clinical case cardiac resynchronization therapy heart failure Medicine R Oleg L. Dubrovin Pavel L. Shugaev A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
description	Background: The main aim of Cardiac Resynchronization Therapy (CRT) is a positive response of the patient, particularly, reduction of the symptoms and improvement of the heart contractility, that can be reached in 5070% of patients. The possibility of appropriate positioning the left ventricular (LV) lead is of great importance for the response to CRT. Certain instruments and technical approaches are used for the placement of the LV lead. Here, we describe the use of the orthodromic snare technique, which is quite rare in practice, but allows one to overcome some anatomical obstacles. Clinical case description: Patient A., suffering from the heart failure with a low ejection fraction and left bundle branch block, was admitted to the hospital for CRT implantation. Before the operation, all the necessary routine instrumental and laboratory diagnostics was performed. During the operation, venography of the cardiac veins revealed unsuitability of the lateral cardiac vein for the placement of the LV lead due to its very small diameter. The posterolateral vein was suitable for the LV lead implantation but still had some anatomical difficulties: an acute angle of inflow and local stenosis in the proximal segment. During the procedure, the following techniques were used without success: positioning the LV lead by a simple translational movement forward, a subselective catheter, introduction of several coronary guides in order to smooth out the acute angle of inflow. These circumstances warranted the use of the orthodromic snare technique for a successful LV lead placement. Conclusion: This clinical case illustrates the possibility of a safe and effective use of the orthodromic snare technique for LV lead implantation. Such anatomical difficulties as a small diameter, acute angle of inflow, local stenosis have also been illustrated and discussed.
format	article
author	Oleg L. Dubrovin Pavel L. Shugaev
author_facet	Oleg L. Dubrovin Pavel L. Shugaev
author_sort	Oleg L. Dubrovin
title	A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
title_short	A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
title_full	A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
title_fullStr	A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
title_full_unstemmed	A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
title_sort	successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case
publisher	Eco-vector
publishDate	2021
url	https://doaj.org/article/c1819f68684c4abfa4987a2afc4610ea
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A successful placement of the left ventricular lead for the cardiac resynchronization device using the orthodromic snare technique: clinical case

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