Key result
Transvenous pacemaker implantation causes acute LIMA occlusion and anterior MI, successfully resolved with PCI.
Why the study?
Acute left internal mammary artery graft occlusion during transvenous dual-chamber pacemaker implantation had not been previously reported.
Case Report (n=1)
First reported case of acute left internal mammary artery graft occlusion causing anterior myocardial infarction during transvenous dual-chamber pacemaker implantation, which was successfully rescued with primary angioplasty and stenting.
Answers are grounded in this paper and cite their sources.
May signal rare LIMA occlusion risk during transvenous pacing post-CABG; first case leaves open need for systematic evaluation.
A patient who had undergone bypass surgery 5 yr earlier, including left internal mammary artery (LIMA) grafting to the left anterior descending artery, underwent transvenous dual-chamber permanent pacemaker implantation for persistent advanced atrioventricular block. Intraoperative LIMA graft obstruction occurred, resulting in anterior myocardial infarction that was treated successfully by primary percutaneous transluminal coronary angioplasty and stenting. This is the first report of the occurrence of this complication during pacemaker implantation.
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Chou et al. (2000) conducted a case report in Persistent advanced atrioventricular block with prior LIMA-to-LAD bypass surgery (n=1). Transvenous dual-chamber permanent pacemaker implantation and subsequent primary percutaneous transluminal coronary angioplasty with stenting was evaluated on Intraoperative LIMA graft obstruction resulting in anterior myocardial infarction. Transvenous dual-chamber pacemaker implantation in 1 patient (5 yr post-CABG) caused acute LIMA graft occlusion and anterior MI, successfully treated by primary PTCA and stenting.
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