Provides technical guidance and tips from a cardiac surgeon's perspective for the implantation of biventricular devices for cardiac resynchronization therapy.
May inform surgical CRT implantation techniques; extends expert guidance but leaves open prospective validation.
Specific problems of cardiosurgical implantation of biventricular devices for cardiac resynchronisation therapy are elucidated elaborately. In particular, the necessity and amount of intraoperative monitoring as well as the appropriate mode of anaesthesia are described. Furthermore, the sequence of lead placement, the technique of coronary sinus intubation using a guiding catheter as well as means to avoid thrombus formation in the coronary sinus are depicted. Biventricular ICD devices should be implanted from a left sided approach to integrate the device into the defibrillation field and to maintain the option of placing an additional subcutaneous array lead. It is of particular cardiosurgical interest that coronary vein leads are applicable for ventricular stimulation in patients after tricuspid valve replacement thus avoiding repeated surgical exposure of the heart.
No takes yet. Share an insight, caveat, or question.
Bert Hansky (2004) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: