CASE REPORT article
Front. Cardiovasc. Med.
Sec. Structural Interventional Cardiology
A Case Report of Successful Implantation of a Leadless Pacemaker via the Left Internal Jugular Vein in a Patient with Mirror-Image Dextrocardia and Absence of the Inferior Vena Cava's Hepatic Segment
Provisionally accepted
- Wuhan Asia Heart Hospital, Wuhan, China
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Mirror-image dextrocardia combined with absence of the hepatic segment of the inferior vena cava (IVC) and continuation of the azygos vein represents an extremely rare dual anatomical variation that significantly increases the technical complexity of leadless pacemaker (LP) implantation. This paper presents a 28-year-old male patient who required permanent pacing therapy due to third-degree atrioventricular block. Preoperative computed tomography angiography (CTA) clearly identified the aforementioned malformations. A Micra AV leadless pacemaker was subsequently implanted successfully via the left internal jugular vein. During the procedure, image mirroring technology was employed to assist the operation, ensuring precise deployment and stable parameters. This case marks the world's first successful LP implantation via the internal jugular vein in a patient with such complex anatomical variations, offering a novel, safe, and feasible approach for similar patients.
Keywords: leadless pacemaker, mirror-image dextrocardia, Hepatic segment interruption of theinferior vena cava, Azygos continuation, Internal jugular approach
Received: 08 Sep 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Bao, Yi and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongwei Yi, 11354968@qq.com
Hongwei Han, 15327298622@189.cn
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