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Minimally Invasive Epicardial Pacemaker Implantation in Neonates with Congenital Heart Block
- Source :
- Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Cardiologia v.109 n.4 2017, Sociedade Brasileira de Cardiologia (SBC), instacron:SBC, Arquivos Brasileiros de Cardiologia, Iss 0 (2017)
- Publication Year :
- 2017
- Publisher :
- Sociedade Brasileira de Cardiologia - SBC, 2017.
-
Abstract
- Background: Few studies have characterized the surgical outcomes following epicardial pacemaker implantation in neonates with congenital complete atrioventricular block (CCAVB). Objective: This study sought to assess the long-term outcomes of a minimally invasive epicardial approach using a subxiphoid access for pacemaker implantation in neonates. Methods: Between July 2002 and February 2015, 16 consecutive neonates underwent epicardial pacemaker implantation due to CCAVB. Among these, 12 (75.0%) had congenital heart defects associated with CCAVB. The patients had a mean age of 4.7 ± 5.3 days and nine (56.3%) were female. Bipolar steroid-eluting epicardial leads were implanted in all patients through a minimally invasive subxiphoid approach and fixed on the diaphragmatic ventricular surface. The pulse generator was placed in an epigastric submuscular position. Results: All procedures were successful, with no perioperative complications or early deaths. Mean operating time was 90.2 ± 16.8 minutes. None of the patients displayed pacing or sensing dysfunction, and all parameters remained stable throughout the follow-up period of 4.1 ± 3.9 years. Three children underwent pulse generator replacement due to normal battery depletion at 4.0, 7.2, and 9.0 years of age without the need of ventricular lead replacement. There were two deaths at 12 and 325 days after pacemaker implantation due to bleeding from thrombolytic use and progressive refractory heart failure, respectively. Conclusion: Epicardial pacemaker implantation through a subxiphoid approach in neonates with CCAVB is technically feasible and associated with excellent surgical outcomes and pacing lead longevity.
- Subjects :
- Heart Defects, Congenital
Male
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system
Pacemaker, Artificial
Cardiac pacing
Treatment outcome
Operative Time
030204 cardiovascular system & hematology
Congenital heart block
Pacemaker implantation
Medical illustration
Infants, Newborns
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Medical Illustration
medicine
Humans
Minimally Invasive Surgical Procedures
Atrioventricular Block
Intraoperative Complications
business.industry
Follow up studies
Cardiac Pacing, Artificial
Infant, Newborn
Reproducibility of Results
Original Articles
Equipment Design
medicine.disease
Surgery
Electrodes, Implanted
Pacemaker
Heart Block
Treatment Outcome
030228 respiratory system
lcsh:RC666-701
Operative time
Female
Radiography, Thoracic
Cardiology and Cardiovascular Medicine
business
Atrioventricular block
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 16784170 and 0066782X
- Volume :
- 109
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Arquivos Brasileiros de Cardiologia
- Accession number :
- edsair.doi.dedup.....608a8cbd7a86f15de615629a59f19bcb