Key result
Totally percutaneous pacing and defibrillation using a transvenous dual-chamber AICD was successfully performed in a patient with a single ventricle post-Fontan operation.
Case Report (n=1)
Demonstrates the feasibility of totally percutaneous ICD implantation in a patient with a classic Fontan circulation, avoiding the morbidity and mortality associated with repeat thoracotomy.
Supports feasibility of percutaneous ICD in Fontan patients; hypothesis-generating and should not yet change practice.
We report the first successful totally percutaneous pacing and defibrillation of a single ventricle in a 52-year-old woman who had undergone a classic Fontan operation (atriopulmonary connection) for tricuspid atresia 21 years earlier. Left ventricular pacing and sensing was obtained with a bipolar lead in the lateral cardiac vein, and defibrillation was obtained with a coronary sinus coil lead and an "active can" in the retromammary position to optimize the current vector. This approach has significant potential benefits because it avoids a repeat thoracotomy, with its associated mortality and morbidity.
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López et al. (2006) conducted a case report in Tricuspid atresia post classic Fontan operation (n=1). Transvenous dual-chamber automatic implantable cardiac defibrillator was evaluated on Successful totally percutaneous pacing and defibrillation. Totally percutaneous pacing and defibrillation using a transvenous dual-chamber AICD was successfully performed in a patient with a single ventricle post-Fontan operation.
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