Feasibility of epicardial implantation of medtronic 3830 lead in a pediatric patient : case report.

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiothoracic Surgery Pub Date : 2024-07-20 DOI:10.1186/s13019-024-02836-2
Dou Yuan, Ke Lin, Yuanning Xu
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Abstract

Background: High-grade atrioventricular block is the primary reason for epicardial permanent pacemaker implantation during the perioperative period in patients with congenital heart disease. Due to the smaller diameter of venous vessels in children, epicardial permanent pacemaker implantation is usually a preferred choice, we report one pediatric patient who received epicardial permanent pacemaker implantation using a new approach.

Case presentation: We present the case of a 2-year-old girl who underwent the modified Konno procedure and Pulmonary valvuloplasty surgery and presented after surgery with a High-grade atrioventricular block. At over 20 days after the patient underwent a redo-sternotomy which epicardial permanent pacemaker implantation. Medtronic Model 4965 Capsure Epi ® steroid-eluting unipolar epicardial pacing lead was immobilized on the surface of the right ear. The Medtronic 3830 pacing lead was screwed obliquely and clockwise under direct view from the surface of the right ventricle to the endocardium near the interventricular septum. The patient's recovery was uneventful.

Conclusion: In this case report, we demonstrate the feasibility and potential benefits of using the Medtronic 3830 lead for epicardial pacing in a pediatric patient with severe cardiac complications following surgery for congenital heart disease. This approach offers a viable alternative to traditional epicardial pacing methods, particularly in complex cases where conventional leads fail to provide stable pacing thresholds.

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一名儿童患者心外膜植入美敦力 3830 导联线的可行性:病例报告。
背景:高度房室传导阻滞是先天性心脏病患者在围手术期植入心外膜永久起搏器的主要原因。由于儿童的静脉血管直径较小,心外膜永久起搏器植入术通常是首选,我们报告了一名使用新方法接受心外膜永久起搏器植入术的儿童患者:我们报告的病例是一名 2 岁女孩,她接受了改良 Konno 手术和肺动脉瓣成形术,术后出现了高度房室传导阻滞。术后 20 多天,患者接受了重做脑室切开术,并植入了心外膜永久起搏器。美敦力 4965 型 Capsure Epi ® 类固醇洗脱单极心外膜起搏导线被固定在右耳表面。在直视下将美敦力 3830 起搏导线从右心室表面斜向顺时针方向拧至室间隔附近的心内膜。患者恢复顺利:在本病例报告中,我们展示了在一名因先天性心脏病手术后出现严重心脏并发症的儿科患者身上使用美敦力 3830 导联进行心外膜起搏的可行性和潜在益处。这种方法为传统的心外膜起搏方法提供了一种可行的替代方案,尤其是在传统导联无法提供稳定起搏阈值的复杂病例中。
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来源期刊
Journal of Cardiothoracic Surgery
Journal of Cardiothoracic Surgery 医学-心血管系统
CiteScore
2.50
自引率
6.20%
发文量
286
审稿时长
4-8 weeks
期刊介绍: Journal of Cardiothoracic Surgery is an open access journal that encompasses all aspects of research in the field of Cardiology, and Cardiothoracic and Vascular Surgery. The journal publishes original scientific research documenting clinical and experimental advances in cardiac, vascular and thoracic surgery, and related fields. Topics of interest include surgical techniques, survival rates, surgical complications and their outcomes; along with basic sciences, pediatric conditions, transplantations and clinical trials. Journal of Cardiothoracic Surgery is of interest to cardiothoracic and vascular surgeons, cardiothoracic anaesthesiologists, cardiologists, chest physicians, and allied health professionals.
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