Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Gabor, S; Prenner, G; Wasler, A; Schweiger, M; Tscheliessnigg, KH; Smolle-Jüttner, FM.
A simplified technique for implantation of left ventricular epicardial leads for biventricular re-synchronization using video-assisted thoracoscopy (VATS).
Eur J Cardiothorac Surg. 2005; 28(6):797-800
Doi: 10.1016/j.ejcts.2005.08.026
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- Führende Autor*innen der Med Uni Graz
- Gabor Sabine
- Co-Autor*innen der Med Uni Graz
- Prenner Günther
- Schweiger Martin
- Smolle-Juettner Freyja-Maria
- Tscheliessnigg Karlheinz
- Wasler Andrae
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- Abstract:
- Objective: Cardiac resynchronisation therapy for treatment of heart failure requires transvenous insertion of both a right ventricular and left ventricular pacing lead. Implantation of the latter by way of the coronary sinus often faits. Therefore, alternative techniques for insertion are required. We applied a simple video-assisted surgical technique (VATS) using only two ports for the insertion of left-ventricular screw-in electrodes. Methods: Fifteen patients (M: 10; F: 5; mean age: 62.2 years; range: 46-76 years) with heart failure meeting the ACC/AHA guidelines for implantation of biventricular pacing underwent transvenous insertion of the right atrial sensor lead and the right ventricular pacing lead. In all of them transvenous implantation of the left ventricular pacing lead failed, and they were planned for VATS. In right-lateral decubitus position and under single-lung ventilation a camera port and a flexible instrumentation port were inserted in the forth intercostal space. By using routine instruments, a T-shaped incision was made lateral to the phrenic nerve and an electrode was screwed in. The lead was guided subcutaneously to the pacemaker. Results: Mean skin-to-skin operating time was 55 +/- 16 min, no conversion to thoracotomy was necessary. All patients were extubated in the operating room and remained in the intensive care unit for less than 24 h. Chest tubes were removed after a mean of 1.6 +/- 0.5 days and the patients were discharged after a mean of 4 +/- 1.3 days. Intraoperative and postoperative pacing thresholds at 1 and 7 months were satisfactory in all cases and there was no lead dislocation. All but two patients had an improvement of their NYHA function class. There was neither surgical morbidity nor mortality. Conclusions: Video-assisted thoracoscopy over two ports seems to be an excellent alternative procedure for epicardial lead implantation. It is readily available and produces good pacing results at a short intervention time and tolerable stress for the patients. (c) 2005 Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Cardiac Pacing, Artificial - methods
- Electrodes, Implanted -
- Female -
- Heart Failure - therapy
- Humans -
- Male -
- Middle Aged -
- Pacemaker, Artificial -
- Thoracic Surgery, Video-Assisted - methods
- Find related publications in this database (Keywords)
- biventricutar resynchronisation
- VATS
- heart failure
- epicardial lead