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- Title
Permanent pacemaker implantation in post one‐and‐a‐half ventricle repair with tricuspid valve replacement in Ebstein anomaly: An innovative technique.
- Authors
Chokesuwattanaskul, Ronpichai; Vithessonthi, Kanyalak; Benjacholamas, Vichai; Lertsapcharoen, Pornthep
- Abstract
Introduction: Transvenous pacemaker implantation in patients post bidirectional Glenn anastomosis in one‐and‐a‐half ventricle repair is usually not feasible. However, with a modified surgical technique for Glenn anastomosis and a combined interventional and electrophysiologic approach, the transvenous pacemaker was successfully implanted. Findings and Conclusions: We reported a novel technique of pacemaker implantation in a 27‐year‐old woman, underlying Ebstein anomaly of the tricuspid valve, who developed intermittent complete atrioventricular block at 5 years after surgical repair. The patient had a tricuspid valve replacement and a novel modified bidirectional Glenn anastomosis for one‐and‐a‐half ventricle repair. The Glenn circuit was conducted by opening a window between the posterior wall of the superior vena cava (SVC) and the anterior wall of the right pulmonary artery (RPA), combined with putting a Goretex membrane in the SVC below the SVC‐RPA window without disconnecting the SVC from the right atrium. The transvenous pacemaker was implanted by perforating the Goretex membrane, then passing the leads from the axillary vein through the perforated membrane and placing them in the coronary sinus and right atrium.
- Subjects
PULMONARY artery physiology; CARDIAC surgery; VENA cava superior; SURGICAL anastomosis; TRICUSPID valve; HEART ventricles; ELECTROPHYSIOLOGY; HEART block; AXILLARY vein; EBSTEIN'S anomaly; HEART atrium; CARDIAC pacemakers; CORONARY arteries
- Publication
Pacing & Clinical Electrophysiology, 2023, Vol 46, Issue 12, p1604
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/pace.14705