Transvenous left ventricular lead placement in a patient with mechanical tricuspid, aortic, and mitral valves
Population
A 62-year-old woman with mechanical aortic, mitral, and tricuspid valve replacement due to rheumatic heart…
Design
Case_report
Authors
Discussion
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Member takes
Implication
May avoid high-risk epicardial leads in mechanical tricuspid valve patients; leaves open need for prospective studies on durability and safety.
Structured PICO
P
Population
A 62-year-old woman with mechanical aortic, mitral, and tricuspid valve replacement due to rheumatic heart disease, sick sinus syndrome, and a single chamber pacemaker (AAIR), referred for upgrade to dual chamber due to symptomatic bradycardia with high-grade AV block.
I
Intervention
Transvenous left ventricular lead placement via the coronary sinus (CS) using an over-the-wire CS lead system advanced into an anterior CS branch, with pacemaker programmed in DDDR mode.
O
Outcome
Successful implantation with adequate pacing threshold and no diaphragmatic stimulation.
Transvenous left ventricular lead placement via the coronary sinus is a feasible approach for ventricular pacing in patients with mechanical tricuspid valves, avoiding high-risk surgical epicardial lead placement.
Cite This Study
Liu et al. (2007) studied this question.