Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-05T16:01:36.129Z Has data issue: false hasContentIssue false

Minimally invasive permanent pacemaker implantation immediately after birth: from delivery room to heart surgery

Permanent Pacemaker Implantation in First Month of Life

Published online by Cambridge University Press:  23 July 2021

Mehmet Taşar*
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
Nur Dikmen Yaman
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
Burcu Arıcı
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
Ömer Nuri Aksoy
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
Huseyin Dursin
Affiliation:
Department of Pediatric Cardiovascular Surgery, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
Aslı Ayaz
Affiliation:
Department of Anesthesia, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
Rümeysa Citli
Affiliation:
Department of Neonatology, Kahramanmaraş Necip Fazıl City Hospital, Kahramanmaraş, Turkey
Senem Özgür
Affiliation:
Department of Pediatric Cardiology, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
İlker Ufuk Sayıcı
Affiliation:
Department of Pediatric Cardiology, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Ankara, Turkey
*
Author for correspondence: Mehmet Taşar, Ankara Dr. Sami Ulus Obstetrics and Gynecology, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey. Tel: +90 505 442 47 80; Fax: +90 312 305 60 14. E-mail: [email protected]

Abstract

Introduction:

Congenital atrioventricular block is diagnosed in uterine life, at birth, or early in life. Atrioventricular blocks can be life threatening immediately at birth so urgent pacemaker implantation techniques are requested. Reasons can be cardiac or non-cardiac, but regardless of the reason, operations are challenging. We aimed to present technical procedure and operative results of pacemaker implantation in neonates.

Materials and methods:

Between June 2014 and February 2021, 10 neonates who had congenital atrioventricular block underwent surgical operation to implant permanent epicardial pacemaker by using minimally invasive technique. Six of the patients were female and four of them were male. Mean age was 4.3 days (0–11), while three of them were operated on the day of birth. Mean weight was 2533 g (1200–3300).

Results:

Operations were achieved through subxiphoidal minimally skin incision. Epicardial 25 mm length dual leads were implanted on right ventricular surface and generators were fixed on the right (seven patients) or left (three patients) diaphragmatic surface by incising pleura. There were no complication, morbidity, and mortality related to surgery.

Conclusion:

Few studies have characterised the surgical outcomes following epicardial permanent pacemaker implantation in neonates. The surgical approach is attractive and compelling among professionals so we aimed to present the techniques and results in patients who required permanent pacemaker implantation in the first month of life.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baruteau, AE, Pass, RH, Thambo, JB, et al. Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management. Eur J Pediatr 2016; 175: 12351248.10.1007/s00431-016-2748-0CrossRefGoogle ScholarPubMed
Hunter, LE, Simpson, JM. Atrioventricular block during fetal life. J Saudi Heart Assoc 2015; 27: 164178.10.1016/j.jsha.2014.07.001CrossRefGoogle ScholarPubMed
Gegieckiene, R, Vankeviciene, R, Kinciniene, O, Liubsys, A. Challenges in the diagnosis and management of isolated congenital complete atrioventricular block in premature newborns. Clin Case Rep 2019; 7: 11971203.10.1002/ccr3.2190CrossRefGoogle ScholarPubMed
Syam, N, Chatel, S, Ozhathil, LC, et al. Variants of transient receptor potential melastatin member 4 in childhood atrioventricular block. J Am Heart Assoc 2016; 5: e001625.10.1161/JAHA.114.001625CrossRefGoogle ScholarPubMed
Paiva, M, Ribeiro, V, Garcia, R, et al. Congenital complete atrioventricular block and dilated cardiomyopathy: new light for an old disease. Case Rep Cardiol 2012; 2012: 451375.Google ScholarPubMed
Khanna, P, Arora, S, Aravindan, A, Prasad, G. Anesthetic management of a 2-day-old with complete congenital heart block. Saudi J Anaesth 2014; 8: 134137.10.4103/1658-354X.125977CrossRefGoogle ScholarPubMed
Zhou, K, Hua, Y. Autoimmune-associated congenital heart block: a new insight in fetal life. Chin Med J (Engl) 2017; 130: 28632871.10.4103/0366-6999.219160CrossRefGoogle Scholar
Costa, R, da Silva, KR, Filho, MM, Carrillo, R. Minimally invasive epicardial pacemaker implantation in neonates with congenital heart block. Arq Bras Cardiol 2017; 109: 331339.Google ScholarPubMed