Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2015; 3(9): 835-837
Published online Sep 16, 2015. doi: 10.12998/wjcc.v3.i9.835
Transhepatic venous approach to permanent pacemaker placement in a patient with limited central venous access
Adeel M Siddiqui, Gregory S Harris, Assad Movahed, Karl S Chiang, Mihail G Chelu, Rajasekhar Nekkanti
Adeel M Siddiqui, Department of Internal Medicine, East Carolina School of Medicine, Greenville, NC 27834, United States
Gregory S Harris, Assad Movahed, Mihail G Chelu, Rajasekhar Nekkanti, Department of Cardiovascular Sciences, East Carolina Brody School of Medicine, Greenville, NC 27834, United States
Karl S Chiang, Vascular Interventional Radiology, Vidant Medical Center, Greenville, NC 27834, United States
Author contributions: Siddiqui AM, Harris GS and Movahed A designed the report; Chelu MG, Chiang KS and Nekkanti R performed the procedure.
Institutional review board statement: Please note that case reports consisting of less than three cases are not required to undergo the IRB approval process at our institution (East Carolina University).
Informed consent statement: Please note that case reports consisting of one case are not required to undergo the informed consent statement process at our institution (East Carolina University).
Conflict-of-interest statement: None of the authors have any disclosures.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adeel M Siddiqui, MD, Department of Internal Medicine, East Carolina School of Medicine, 115 Heart Drive, Greenville, NC 27834, United States. siddiquia@ecu.edu
Telephone: +1-252-7443597 Fax: +1-252-7443987
Received: March 10, 2015
Peer-review started: March 12, 2015
First decision: April 27, 2015
Revised: May 15, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: September 16, 2015
Core Tip

Core tip: End-stage renal disease patients pose a great challenge to establish central venous access. In situations when life-saving cardiac procedures are required in such patients, the clinician must use non-traditional venous access sites to perform these procedures. In our case report, we illustrate the novel use of the trans-hepatic venous access route to implant a single-lead permanent cardiac pacemaker in a patient with bradycardia and hypotension. Additionally, we describe the technical challenges associated with this procedure.