How to reduce high DFTS for Right side Implant Azygous transvene Fail but SUB Q Coil worked AUDIO

With destination VAD we are now seeing more very high DFTs. For right side implant I usually place Transvene coil in left subclavian. The coil simulates the hot can vector. However in this case the plan was for L dialysis fistula so we cant place Transvene coil in the L Subclavian. Used 5-F AL-1 to access Azygous from right. First we placed Transvene lead in the azygous but the DFT's remained hight. We considered the sub-Q coil but how to get it to the left side behind the heart? Out od desperation placed sub-Q coil in azygous (trimmed silicone tip first to make isodiametric) #DFT #coil

Видео How to reduce high DFTS for Right side Implant Azygous transvene Fail but SUB Q Coil worked AUDIO канала BIVTIPS