Key result
Temporary transvenous pacing and sensing-mode reprogramming enable safe open heart surgery in a pacemaker-dependent patient.
Case Report (n=1)
Open heart surgery can be safely conducted in a pacemaker-dependent patient with multidisciplinary perioperative device management, including reprogramming and temporary pacing.
May guide device management in pacemaker-dependent cardiac surgery patients; hypothesis-generating case report requiring prospective validation.
With changing cohort of cardiac patients, elderly patients with comorbidities like a patient with a pacemaker may be encountered in clinical practice.In patients with a pacemaker undergoing noncardiac surgery, electromagnetic interference can alter the function of a permanent pacemaker.Additional concerns during open heart surgery in a patient with a permanent pacemaker are lead displacement with venous cannulation, electrical activity during cardioplegia and damage to the device by defibrillation.Management of a patient with a pacemaker for a surgery calls for a multidisciplinary approach with involvement of cardiologist, electrophysiologist, device manufacturer, anesthesiologist, and cardiac surgeon.To the best of our knowledge, there are no case reports or guidelines about a patient with a pacemaker coming for cardiac surgery, and we report the perioperative management of a pacemaker dependent patient undergoing aortic valve replacement for severe aortic stenosis.
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Lakshmi Adalagere Sathyanarayana (2018) conducted a case report in Severe calcific aortic stenosis with a dual chamber pacemaker (n=1). Open heart surgery with perioperative pacemaker management was evaluated on Successful completion of surgery and perioperative management without pacemaker-related complications. Open heart surgery was safely conducted in a pacemaker-dependent patient by reprogramming the generator to a sensing mode, using a temporary transvenous pacemaker, and minimizing defibrillation.
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