Accidental entry of an implantable cardioverter defibrillator lead into the left hepatic vein detected by transesophageal echocardiography.
Orihashi K. Matsuura Y. Sueda T. Shikata H. Mitsui N. Sueshiro M.
First Department of Surgery, Hiroshima University School of Medicine, Japan.
We report a case of accidental entry of an implantable cardioverter defibrillator lead into the hepatic vein, which was not noted on fluoroscopy but was apparent when transesophageal echocardiography (TEE) was used incidentally. The lead was depicted in the hepatic vein as strongly echogenic, accompanied by an acoustic shadow. Additional bending of the stylet was helpful for successful advancement of the lead. TEE provides additional information in such cases, although indications for its use should be explored because of its possible complications.