Complications of permanent cardiac pacing in patients with persistent left superior vena cava

Polewczyk, Anna; Kutarski, Andrzej; Czekajska−Chehab, Elżbieta; Świętochowska, Elżbieta; Boczar, Krzysztof; Janion, Marianna

doi:10.5603/cj.a2014.0006

Cited by 21 publications

(14 citation statements)

References 23 publications

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“…Patient and disease-specific characteristics are associated with an operation's technical complexity [1][2][3][4][5][6]. Hence, a methodical preparation towards challenging surgical procedures, encompassing patient-specific features, may have a significant effect on improving both the quality and outcome of surgery.…”

Section: Introductionmentioning

confidence: 99%

Is patient-specific pre-operative preparation feasible in a clinical environment? A systematic review and meta-analysis

Yiasemidou

Glassman

Jayne

et al. 2018

Computer Assisted Surgery

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Technical difficulty of an operation is associated with patient and disease characteristics, indicating the necessity for surgeons to exercise patient-specific preparation. Such methods have been shown to be effective in the simulation suite, however, application in a real clinical environment has been sporadic. This systematic review attempts to answer if patient-specific preparation in challenging surgical procedures is feasible. A systematic review of OvidMedline, Embase and all Evidence Based Medicine review databases, was conducted in search of studies who described surgical rehearsals in all specialties. Following the application of defined inclusion and exclusion criteria relevant data were extracted and summarised. Descriptive synthesis was performed for all included studies and meta-analysis of data was applied when possible. Of fourty-nine studies included, thirty-seven were case-series, ten were non-randomised comparative trials and two randomised controlled trials. Accuracy of applied methods ranged from 66.7 to 100% and a good outcome was seen in 60-100% of operations. Meta-analysis of studies comparing rehearsals to real procedures (same patients) showed that simulated procedures were significantly faster than real ones (SMD ¼ À1.56 [À2.19, À0.93] p < 0.00001) but were similar in other outcomes (fluoroscopy time: SMD ¼ À0.1 [À0.63, 0.42] p ¼ 0.7, fluoroscopy volume: SMD ¼ À0.43[À0.97, 0.11], p ¼ 0.12). Meta-analysis of studies comparing pre-operative rehearsals to standard treatment (two distinct groups of patients), demonstrated that real procedures were performed quicker if pre-operative rehearsal took place (SMD ¼ À0.47 [À0.79, À0.16], P ¼ 0.003) but the immediate clinical outcome was similar for practiced and not practiced operations (SMD ¼0.03[À0.23, 0.29], p ¼ 0.82). Current evidence suggests that patient-specific pre-operative preparation is feasible and safe and decreases operational time.

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Section: Introductionmentioning

confidence: 99%

Is patient-specific pre-operative preparation feasible in a clinical environment? A systematic review and meta-analysis

Yiasemidou

Glassman

Jayne

et al. 2018

Computer Assisted Surgery

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“…7 It is important to perform a venous angiography to identify LVSC, to evaluate the angle of the CS orifice and the possible presence of a double vena cava. 8 To insert the lead into the CS, it may be useful to use guides with atypical curves. 9 Many patients have bilateral SVCs, and the right SVC is a viable option in case of difficulty in the left approach.…”

Section: Discussionmentioning

confidence: 99%

Active fixation coronary sinus lead in a patient with persistence of left superior vena cava

Caravati

Golino

et al. 2020

Clinical Case Reports

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“…Venous collaterals representing remnants of persistent left superior vena cava may develop after Fontan surgery and allow access to the coronary sinus. Manipulating leads as described in section 2.4 may permit placement of atrial and ventricular leads in these patients, even though it may prove to be challenging [35]. Placement of pacing leads through the inferior vena cava in patients after Glenn shunt risks atrial lead dislodgement in 20% of patients and venacaval thrombosis/phlebitis [36,37].…”

Section: Discussionmentioning

confidence: 99%

Endocardial transvenous pacing in patients with surgically palliated univentricular hearts: A review on different techniques, problems and management

Umamaheshwar

Singh

Sivakumar

2019

Indian Pacing and Electrophysiology Journal

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Fontan surgery and its modifications have improved survival in various forms of univentricular hearts. A regular atrial rhythm with atrioventricular synchrony is one of the most important prerequisite for the long-term effective functioning of this preload dependent circulation. A significant proportion of these survivors need various forms of pacing for bradyarrhythmias, often due to sinus nodal dysfunction and sometimes due to atrioventricular nodal block. The diversion of the venous flows away from the cardiac chambers following this surgery takes away the simpler endocardial pacing options through the superior vena cava. The added risks of thromboembolism associated with endocardial leads in systemic ventricles have made epicardial pacing as the procedure of choice. However challenges in epicardial pacing include surgical adhesions, increased pacing thresholds leading to early battery depletion and frequent lead fractures. When epicardial pacing fails, endocardial lead placement is equally challenging due to lack of access to the cardiac chambers in Fontan circulation. This review discusses the univentricular heart morphologies that may warrant pacing, issues about epicardial pacing, different techniques for endocardial pacing in patients with disconnected superior vena cava, pacing in different modifications of Fontan surgeries, issues of systemic thromboembolism with endocardial leads, atrioventricular valve regurgitation attributed to pacing leads and device infections. In a vast majority of patients following Glenn shunt and Senning surgery, an epicardial pacing and lead replacement is always feasible though technically very difficult. This article highlights the different options of transatrial and transventricular endocardial pacing.

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Complications of permanent cardiac pacing in patients with persistent left superior vena cava

Abstract: (Cardiol J 2014; 21, 2: 128-137)

Cited by 21 publications

References 23 publications

Is patient-specific pre-operative preparation feasible in a clinical environment? A systematic review and meta-analysis

Is patient-specific pre-operative preparation feasible in a clinical environment? A systematic review and meta-analysis

Active fixation coronary sinus lead in a patient with persistence of left superior vena cava

Endocardial transvenous pacing in patients with surgically palliated univentricular hearts: A review on different techniques, problems and management

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