エジマ コウイチロウ   EJIMA KOICHIRO
  江島 浩一郎
   所属   医学部 医学科(東京女子医科大学病院)
   職種   特任准教授
論文種別 症例報告
言語種別 英語
査読の有無 査読あり
表題 Left brachiocephalic vein occlusion in a patient with an aortic arch aneurysm: Rare cause of obstraction for a pacemaker implantation
掲載誌名 正式名:Journal of Cardiology Cases
略  称:J Cardiol Cases
ISSNコード:18785409
掲載区分国内
出版社 published by Elsevier B. V. on behalf of the Japanese College of Cardiology
巻・号・頁 9(1),32-34頁
著者・共著者 EJIMA Koichiro†*, SHODA Morio, MANAKA Tetsuyuki, YASHIRO Bun, KATO Ken, YOSHIDA Kentaro, NUKI Toshiaki, HAGIWARA Nobuhisa
発行年月 2014/01
概要 Venous occlusions or anatomic variants are unexpectedly encountered during transvenous pacing lead implantation procedures. A 78-year-old man, who had been medically treated for a thoracic and abdominal dissecting aortic aneurysm was referred to our hospital for treatment of congestive heart failure due to complete atrioventricular block with bradycardia. At the time of the pacemaker implantation, the guidewire for inserting the introducer sheath could not be advanced into the left brachiocephalic vein. A venogram and contrast-enhanced chest multi-detector computed tomography revealed an obstruction of the left brachiocephalic vein at the confluence of the left internal jugular and left subclavian veins, and there was collateral blood circulation. We abandoned introducing the pacemaker lead from the left side, and implanted the pacemaker in his right anterior chest. In this case, the left brachiocephalic vein was occluded due to dilatation and elongation of the aortic arch aneurysm and the deviated left common carotid artery. This case illustrates the importance of the assessment of the patency of the left brachiocephalic vein prior to the central venous approach from the left internal jugular and left subclavian veins in patients with aortic arch aneurysms. <Learning objective: Venous occlusions or anatomic variants are unexpectedly encountered during transvenous pacing lead implantation procedures. Dilatation and elongation of the aortic arch aneurysm and the deviated left common carotid artery can be a cause of a left brachiocephalic vein occlusion. It is important to assess the patency of the left brachiocephalic vein prior to the central venous approach from the left internal jugular and left subclavian veins in patients with aortic arch aneurysms.>.
DOI 10.1016/j.jccase.2013.09.003
PMID 30546779