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"tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "295" "paginaFinal" => "296" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O que não mata engorda!" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 491 "Ancho" => 1700 "Tamanyo" => 169263 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Transthoracic echocardiogram, apical 4-chamber view; (B) detail of the previous image at the level of the left ventricular apex.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Magalhães, Nuno Bettencourt, Francisco Sampaio, Sofia Carvalho, J. Ilídio Moreira, Vasco Gama" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Magalhães" ] 1 => array:2 [ "nombre" => "Nuno" "apellidos" => "Bettencourt" ] 2 => array:2 [ "nombre" => "Francisco" "apellidos" => "Sampaio" ] 3 => array:2 [ "nombre" => "Sofia" "apellidos" => "Carvalho" ] 4 => array:2 [ "nombre" => "J. Ilídio" "apellidos" => "Moreira" ] 5 => array:2 [ "nombre" => "Vasco" "apellidos" => "Gama" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255115000153" "doi" => "10.1016/j.repc.2014.11.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115000153?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000586?idApp=UINPBA00004E" "url" => "/21742049/0000003400000004/v2_201504291249/S2174204915000586/v2_201504291249/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Implantation of a cardiac resynchronization therapy defibrillator through a persistent left superior vena cava" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "297" "paginaFinal" => "298" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Miguel Nobre Menezes, Ana Bernardes, João de Sousa, Pedro Marques" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Miguel" "apellidos" => "Nobre Menezes" "email" => array:1 [ 0 => "mnmenezes.gm@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Bernardes" ] 2 => array:2 [ "nombre" => "João" "apellidos" => "de Sousa" ] 3 => array:2 [ "nombre" => "Pedro" "apellidos" => "Marques" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Serviço de Cardiologia, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Implantação de CRT-D através de veia cava superior esquerda persistente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 849 "Ancho" => 990 "Tamanyo" => 124161 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray immediately after implantation of a cardiac resynchronization therapy defibrillator through a persistent left superior vena cava.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0010" class="elsevierStylePara elsevierViewall">Persistence of the left superior vena cava is rare, being found in 0.3–2% of the general population, and shows considerable anatomical variability. We report the case of a 64-year-old man with idiopathic dilated cardiomyopathy, admitted electively for implantation of a cardiac resynchronization therapy defibrillator. Access was achieved via the left cephalic vein, but the lead was seen to advance to the left of the spinal column. Contrast injection revealed a persistent left superior vena cava draining into the right atrium close to the coronary sinus ostium.</p><p id="par0015" class="elsevierStylePara elsevierViewall">On encountering this congenital defect, many operators immediately decide to use special techniques, particularly for biventricular devices; some adopt a right approach to facilitate catheter manipulation, others use a hybrid technique (right and left in the same procedure), and some implant the right ventricular lead in the left ventricle. However, these techniques can be rather complex and carry an increased risk of infection and vascular injury, especially with a bilateral approach. Therefore, since according to various authors and our own experience conventional implantation can be safe and effective, it was decided to attempt this approach first. All the leads were positioned by the conventional technique, including a quadripolar lead in the coronary sinus (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">At three-month follow-up stimulation thresholds were satisfactory and effective resynchronization had been achieved. In conclusion, although persistence of the left superior vena cava hampers implantation, the simplest approach should be attempted first.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appears in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-11-18" "fechaAceptado" => "2014-11-25" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Nobre Menezes M, Bernardes A, de Sousa J, et al. Implantação de CRT-D através de veia cava superior esquerda persistente. Rev Port Cardiol. 2015;34:297–298.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 849 "Ancho" => 990 "Tamanyo" => 124161 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray immediately after implantation of a cardiac resynchronization therapy defibrillator through a persistent left superior vena cava.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003400000004/v2_201504291249/S2174204915000598/v2_201504291249/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003400000004/v2_201504291249/S2174204915000598/v2_201504291249/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000598?idApp=UINPBA00004E" ]
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