Inadvertent Placement of Pacemaker Lead into the Systemic Ventricle in Repaired D-Transposition of the Great Arteries (original) (raw)
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Impact of pacing on systemic ventricular function in L-transposition of the great arteries
The Journal of Thoracic and Cardiovascular Surgery, 2016
Objective(s): To assess the impact of univentricular versus biventricular pacing (BiVP) on systemic ventricular function in patients with congenitally corrected transposition of the great arteries (ccTGA). Methods: We performed a retrospective review of all patients with a diagnosis of ccTGA who underwent pacemaker insertion. From 1993 to 2014, 53 patients were identified from the cardiology database and surgical records. Results: Overall mortality was 7.5% (n ΒΌ 4). One patient required transplantation and 3 late deaths occurred secondary to end-stage heart failure. Median follow-up was 3.7 years (range, 4 days to 22.5 years). Twenty-five (47%) underwent univentricular pacing only, of these, 8 (32%) developed significant systemic ventricular dysfunction. Twenty-eight (53%) received BiVP, 17 (26%) were upgraded from a dual-chamber system, 11 (21%) received primary BiVP. Fourteen (82%) of the 17 undergoing secondary BiVP demonstrated systemic ventricular dysfunction at the time of pacer upgrade, with 7 (50%) demonstrating improved systemic ventricular function after pacemaker upgrade. Overall, 42 (79%) patients underwent univentricular pacing, with 22 (52%) developing significant systemic ventricular dysfunction. In contrast, the 11 (21%) who received primary BiVP had preserved systemic ventricular function at latest follow-up. Conclusions: Late-onset systemic ventricular dysfunction is a major complication associated with the use of univentricular pacing in patients with ccTGA. All patients with ccTGA who develop heart block should undergo primary biventricular pacing, as this prevents late systemic ventricular dysfunction. Preemptive placement of BiVP leads at the time of anatomical repair or other permanent palliative procedure will facilitate subsequent BiVP should heart block develop.
Pacing and Clinical Electrophysiology, 1993
An 11-year-old girl who underwent Mustard's operation for complele (ransposition of the great arteries in infancy, developed Mobitz lype II second-degree AV block 8V2 years later. A transvenous, active fixation left ventricular lead was inserted and connected to a rate responsive pacemaker. Two years later (he lead dislodged due (o the child's growth. A new active fixation electrode was positioned in the left ventricle beJow the pulmonary valve, leaving an electrode loop in (he ventricle. Such an approach may prevent lead dislodgement due to growth after intraatrial repair for transposition of the great arteries, hut regular radiological or echocardiographic follow-up of lead position is recommended in these patients. (PACE, Vol. 16, September 1993) transposition of great arteries, pacemaker, cardiac pacing Address for reprints: Michal
D-Transposition of the Great Arteries: A New Era in Cardiology
Cardiovascular Innovations and Applications
Before the 1950s, D-transposition of the great arteries was associated with nearly 90% mortality within the first year of life. The Mustard and Senning procedures resulted in a significant increase in the lifespan of these patients but with notable long-term complications, including arrhythmias, sinus node dysfunction, chronotropic incompetence, and right ventricular systolic dysfunction. The arterial switch operation (first described by Adib Jatene) initially resulted in nearly universal death. However, the use of coronary buttons for coronary artery translocation has improved operative survival dramatically. It is now considered the treatment of choice in patients amendable to the arterial switch operation. Considered an anatomic repair, resulting in concordant ventriculoarterial connections and a systemic left ventricle, the arterial switch operation reduces the incidence of ventricular dysfunction. However, it is also associated with long-term complications, including aortic roo...
https://www.ijrrjournal.com/IJRR\_Vol.7\_Issue.2\_Feb2020/Abstract\_IJRR0017.html, 2020
Pacemaker implantation in congenitally corrected transposition of the great arteries can be challenging due to distorted cardiac anatomy that in some cases it may be accompanied by other anomalies. The present report outlines a rare case of congenitally corrected transposition of the great arteries, asymptomatic until the seventh decade of life. Keywords: congenital heart disease, congenitally corrected transposition of the great arteries, double discordance, levocardia, permanent pacemaker, situs solitus
Journal of the American College of Cardiology, 1988
Ektmrhyrlc4wic studies were wfmmed at 12.7 2 4 mrdb.Cp&pe&l~ely io 20 p&Is *ho bnd the srlerkl SWikh repair a, I ,a 120 days ,nwan 13 + 26 (SD,, la* d-lrmsposilii of the gRp* arteries. PreoperaUve ektmmrdlkgrams w.xr, PI ret re"eakd ml ectoplc otrial rhythm in cme patient. Postoperaative rest ECGs revealed h-mint pmtapentiw ectopic atrial or juoctimal rhythm-s in two patknb, interndttent eclopie atrial rhythm ia MO and right badk branch black in nine wilh a normal QRS a&. In mtditian, ambulatory monitor mwdings revealed infrque.1 premahwe vmtrkutar wqdexs in five patients. Catbettr endnxardlal mapping revealed sinus rhvtbm in 1 ~,tents md ectaoic at&d rtwttm ia 1 &I dtfs mu signltienntly earlier atler tk switch repair tka,, after the Mm&d remr.
Inadvertent implantation of pacemaker lead in the left ventricle: kill two birds with one stone
International cardiovascular research journal, 2014
We report an asymptomatic patient in whom the intravenous pacemaker (PM) lead was inadvertently implanted in LV through the perforated interventricular septum. He had no embolic events during the last 9 years after the implantation. Possible explanation of the uncomplicated follow-up period is that the patient had been taking warfarin because of mechanical mitral valve prosthesis.