A challenging case of transvenous pacemaker implant in a patient with anomalous pulmonary venous drainage

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.