Guiding catheter delivery system

Locating the coronary sinus os can be quite problematic, given the heart failure patient s distorted anatomy. Table 4.16 outlines the techniques devised to can-nulate the coronary sinus. If a simple stylet-driven lead coronary sinus placement is undertaken, then coronary sinus access is dependent on the operator s skill, knowledge of the coronary sinus anatomy, and favorable tributaries for safe, reliable placement. Coronary sinus os localization is much easier with a guiding catheter delivery system. The operator simply selects the guiding... 

Electrosurgical cutting and coagulation device Nonpowered suction apparatus Hydraulic/mechanical impotence device Implantable pacemaker Peritoneal dialysate delivery system Catheter introducer Catheter guide wire... 

Fig. 4.80 A. Lead delivery system with guide catheters. Hemostatic valve, guide wires and EP catheter. Courtesy Guidant/Boston Scientific. B. Family of guide catheters with multiple distal tip curves. Courtesy Medtronic Corporation. C. Hemostatic valve and flush system. Courtesy Guidant/Boston Scientific, (from Belott PH Implantation Techniques for Cardiac resynchronization Therapy Barold SS, Mugica J Fifth Decade of Cardiac Pacing. Armonk NY Futura. 2004 pp 10)...

Inroads to successful LV lead implantation have been achieved through collective sharing of implant experiences (5). New sheath delivery systems, catheters, and guide wires continue to improve LV lead implantation success. It is hoped that this chapter will serve as a useful springboard to improving outcomes with LV lead implantation. 

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