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CLINICAL STUDY

Coronary vein balloon angioplasty forleft ventricular pacemaker lead implantation

Bert Hansky, MD^*,*, Barbara Lamp, MD, Kazutomo Minami, MD^*, Johannes Heintze, MD,, Leon Krater, MD, Dieter Horstkotte, MD, Reiner Koerfer, MD^* and J.ürgen Vogt, MD

^* Department of Thoracic and Cardiovascular Surgery, Bad Oeynhausen, Germany
Department of Cardiology, Heart Center NRW, University of Bochum, Bad Oeynhausen, Germany

Manuscript received March 4, 2002; revised manuscript received May 29, 2002, accepted July 8, 2002.

^* Reprint requests and correspondence: Dr. Bert Hansky, Herz- und Diabeteszentrum NRW, Georgstrasse 11, 32545 Bad Oeynhausen, Germany.
bhansky{at}hdz-nrw.de

OBJECTIVES: Retrospective analysis of five cases of coronary vein balloon angioplasty performed to allow insertion of left ventricular pacing leads.

BACKGROUND: Coronary vein stenoses or an insufficient vessel caliber can preclude transvenous placement of coronary vein leads.

METHODS: We compared our total patient population (n = 218), in whom we implanted coronary vein leads, to those five patients who required coronary vein angioplasty to allow lead placement. Standard over-the-wire coronary artery balloon angioplasty catheters were used to dilate the vessel to 2.5 mm (n = 3) or 3.5 mm (n = 2).

RESULTS: Transvenous lead placement succeeds in >99% of patients. Four cases of target vein stenoses and one case of a vein of insufficient caliber were successfully treated by balloon angioplasty. There were no complications.

CONCLUSIONS: Coronary vein angioplasty is an effective and safe technique to permit transvenous left ventricular pacing lead insertion in cases of target vein stenoses or insufficient target vein caliber.

Abbreviations and Acronyms   ICD   implantable cardioverter-defibrillator   LV   left ventricular   OTW   over-the-wire

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