Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy

Introduction. Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization in patients with symptomatic heart failure and left bundle branch block (LBBB) on optimal drug therapy. Among all, the reasons for “non-response” to CRT pacemaker could be the failure to achieve optimal left...

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Main Authors: Đurić Predrag, Mladenović Zorica, Drobnjak Dragan, Spasić Marijan, Jović Zoran, Đurić Ivica, Bogdanović Predrag, Romanović Radoslav, Milašinović Goran
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000061D.pdf
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author Đurić Predrag
Mladenović Zorica
Drobnjak Dragan
Spasić Marijan
Jović Zoran
Đurić Ivica
Bogdanović Predrag
Romanović Radoslav
Milašinović Goran
author_facet Đurić Predrag
Mladenović Zorica
Drobnjak Dragan
Spasić Marijan
Jović Zoran
Đurić Ivica
Bogdanović Predrag
Romanović Radoslav
Milašinović Goran
author_sort Đurić Predrag
collection DOAJ
description Introduction. Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization in patients with symptomatic heart failure and left bundle branch block (LBBB) on optimal drug therapy. Among all, the reasons for “non-response” to CRT pacemaker could be the failure to achieve optimal left ventricular (LV) lead position due to severe curve or stenosis/occlusion of the target vein. Case report. We presented a 79-old-male patient, New York Heart Association (NYHA) class III, with atrial fibrillation, chronic coronary syndrome (CCS), and prior myocardial infarction. The patient underwent coronary artery bypass surgery and mechanical prosthetic aortic valve implantation. He was indicated for CRT. The patient′s venogram revealed ostial/proximal severe curve and stenosis of the posterolateral vein, the only vein of coronary sinus that led to anatomically optimal LV segment for stimulation. After the balloon angioplasty of the curved and stenotic portion of the target vein with compliant balloon 4.0 × 30 mm, a satisfactory and stable position of quadripolar LV lead was achieved. Conclusion. Compliant balloon angioplasty could be a safe and efficient way to override severe coronary vein stenosis in some CRT cases.
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spelling doaj-art-70ce472b05b74d0fb71299d0b3cd619f2025-08-20T03:19:12ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178111229123310.2298/VSP200508061D0042-84502000061DBalloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapyĐurić Predrag0Mladenović Zorica1https://orcid.org/0000-0002-4668-3922Drobnjak Dragan2Spasić Marijan3Jović Zoran4Đurić Ivica5Bogdanović Predrag6Romanović Radoslav7Milašinović Goran8Military Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia Military Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia Military Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia Military Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia Military Medical Academy, Clinic for Cardiology and Urgent Internal Medicine, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaClinical Center of Serbia, Referral Pacemaker Center, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaIntroduction. Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization in patients with symptomatic heart failure and left bundle branch block (LBBB) on optimal drug therapy. Among all, the reasons for “non-response” to CRT pacemaker could be the failure to achieve optimal left ventricular (LV) lead position due to severe curve or stenosis/occlusion of the target vein. Case report. We presented a 79-old-male patient, New York Heart Association (NYHA) class III, with atrial fibrillation, chronic coronary syndrome (CCS), and prior myocardial infarction. The patient underwent coronary artery bypass surgery and mechanical prosthetic aortic valve implantation. He was indicated for CRT. The patient′s venogram revealed ostial/proximal severe curve and stenosis of the posterolateral vein, the only vein of coronary sinus that led to anatomically optimal LV segment for stimulation. After the balloon angioplasty of the curved and stenotic portion of the target vein with compliant balloon 4.0 × 30 mm, a satisfactory and stable position of quadripolar LV lead was achieved. Conclusion. Compliant balloon angioplasty could be a safe and efficient way to override severe coronary vein stenosis in some CRT cases.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000061D.pdfcardiac resynchronization therapyheart failurecompliant balloonangioplasty
spellingShingle Đurić Predrag
Mladenović Zorica
Drobnjak Dragan
Spasić Marijan
Jović Zoran
Đurić Ivica
Bogdanović Predrag
Romanović Radoslav
Milašinović Goran
Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
Vojnosanitetski Pregled
cardiac resynchronization therapy
heart failure
compliant balloon
angioplasty
title Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
title_full Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
title_fullStr Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
title_full_unstemmed Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
title_short Balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
title_sort balloon angioplasty of cardiac vein in a patient treated by cardiac resynchronization therapy
topic cardiac resynchronization therapy
heart failure
compliant balloon
angioplasty
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84502000061D.pdf
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