Key result
A dual-chamber leadless pacemaker was utilized in a d-TGA patient after a Senning procedure, a population where transvenous leads carry a 30-50% risk of thrombosis or occlusion.
Why the study?
Adults with d-TGA after atrial baffle procedures frequently require pacemakers, but transvenous leads often cause thrombosis and venous or baffle occlusion.
Case Report (n=1)
Describes the use of a dual-chamber leadless pacemaker in a patient with d-TGA after a Senning procedure, potentially avoiding the high risk of thrombosis and occlusion associated with transvenous leads in this population.
May offer alternative pacing in post-Senning d-TGA; hypothesis-generating and should not yet change practice.
Although the arterial switch operation is now the standard of care for dextro-transposition of the great arteries (d-TGA), many adults underwent Mustard and Senning (atrial baffle) procedures as children. Approximately 30% of these patients require pacemakers by adulthood (1). Arrhythmias requiring pacemakers or implantable cardioverter-defibrillators (ICDs) are among the most common long-term complications for these patients (2). Transvenous pacemaker leads may cause thrombosis and partial or total occlusion of the subclavian vein or baffle in 30-50% of patients with prior Mustard surgery.
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Tanawuttiwat et al. (2024) conducted a case report in dextro-transposition of the great arteries (d-TGA) after Senning procedure (n=1). Dual-chamber leadless pacemaker was evaluated. A dual-chamber leadless pacemaker was utilized in a d-TGA patient after a Senning procedure, a population where transvenous leads carry a 30-50% risk of thrombosis or occlusion.
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