Key result
Limited lower sternotomy enables successful epicardial DDD pacemaker implantation in superior vena cava occlusion.
Why the study?
Intravenous lead implantation is difficult in patients with superior vena cava occlusion, necessitating alternative pacemaker implantation methods.
Case Report (n=1)
Epicardial DDD pacemaker implantation through a limited lower sternotomy is a viable alternative when intravenous lead implantation is difficult due to superior vena cava occlusion.
Answers are grounded in this paper and cite their sources.
May offer a surgical option in SVC occlusion when transvenous access fails; single-case data leave comparative safety and efficacy open.
SAKO, H., et al.: An Implantation of DDD Epicardial Pacemaker Through Ministernotomy in a Patient with a Superior Vena Cava Occlusion. We successfully implanted a DDD epicardial pacemaker through a limited lower sternotomy in a patient whose superior vena cava had been occluded. Both epicardial leads were connected to the generator placed in the existing subcutaneous pocket on the left pectoral region through the second intercostal space. This approach provided excellent exposure and easy access to both the right appendage and the right ventricle. The combined procedure of epicardial DDD pacemaker implantation through a limited lower sternotomy with placement of the generator in the pectoral subcutaneous pocket is one of the better methods when intravenous lead implantation is difficult. (PACE 2003; 26:778–780)
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Sako et al. (2003) conducted a case report in Superior vena cava occlusion (n=1). DDD epicardial pacemaker implantation through a limited lower sternotomy was evaluated on Procedural success. Implantation of a DDD epicardial pacemaker through a limited lower sternotomy was successfully performed in a patient with superior vena cava occlusion.
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