A Case Highlighting the Technical Challenges of Pacing Device Implantation in Partial Anomalous Pulmonary Venous Drainage of the Right Superior Pulmonary Vein into Superior Vena Cava

Abstract

Partial anomalous pulmonary venous drainage (PAPVD) is a congenital heart disease that can often remain undiagnosed due to its asymptomatic nature. The prevalence was thought to be around 0.4% to 0.7% in the adult population.[1] We report a case of right superior pulmonary venous drainage into the superior vena cava (SVC) in a patient with known hypertrophic cardiomyopathy and impaired left ventricular systolic function. The anomalous drainage pattern was identified during device implantation, necessitating real-time troubleshooting. Contrast fluoroscopy played a critical role in delineating the aberrant anatomy, guiding wire manipulation through the superior vena cava while avoiding entry into the right pulmonary vein.