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A 67-year-old man receiving hemodialysis because of kidney failure resulting from renovascular disease was admitted to the hospital for revision of dialysis access. Six months earlier, a dual-chamber, permanent pacemaker had been implanted in the right side of the chest for the treatment of complete heart block. The dialysis catheter, inserted into the left internal jugular vein under fluoroscopic guidance, showed a left superior vena cava draining into the right atrium through a coronary sinus. A chest radiograph showed the pacemaker, with leads in the right subclavian vein and right superior vena cava, and a catheter in the left internal . . . [Full Text of this Article] |
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