TY  - EJOU
AU  - Elenizi, Khaled 
AU  - Aldeen, Abdullah Sharaf 
AU  - Alotaibi, Nasser 
AU  - Fagir, Nagy 
AU  - Hado, Hussien 
AU  - Aldossari, Mubarak 

TI  - Persistent Left Superior Vena Cava with Severely Dilated Coronary Sinus: A Rare Case Report of Failed CRT-P and Successful Dual-Chamber Pacemaker Implantation
T2  - Structural and Congenital Heart Disease

PY  - 2025
VL  - 20
IS  - 5
SN  - 3071-1738

AB  - Persistent left superior vena cava (PLSVC) is a rare congenital anomaly that may complicate cardiac procedures when associated with a dilated coronary sinus (CS) and conduction disturbances. We report the case of a 27-year-old male with Wilson’s disease who presented with complete heart block. Echocardiography showed biatrial enlargement and severe CS dilation, while contrast-enhanced computed tomography (CT) confirmed PLSVC draining into the CS without a bridging vein. Anatomical constraints prevented cardiac resynchronization therapy, and dual-chamber pacemaker implantation proved technically challenging due to lead placement difficulties. This case highlights the importance of thorough preoperative assessment and individualized pacing strategies in patients with PLSVC, in order to anticipate anatomical challenges and optimize outcomes.
KW  - Persistent left superior vena cava; coronary sinus; complete heart block; Wilson’s disease; cardiac resynchronization therapy

DO  - 10.32604/chd.2025.071226