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Single midline approach for permanent pacemaker implantation in children
Vichai Benjacholamas1, Piroj Chotivittayatarakorn, Porntep Lertsupchareon
1Cardiothoracic Unit, Department of Surgery, Faculty of Medicine, Chulalongkorn Hospital, Bangkok, Thailand. vichaicu@hotmail.com
Insights
This study details a safe and effective method for permanent pacemaker implantation in 12 children, utilizing a single midline approach for both lead and generator placement. The technique proved rapid and simple, particularly for neonates and infants, with no early complications observed.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Surgical Innovation
Background:
- Permanent pacemaker implantation is crucial for managing bradyarrhythmias in pediatric patients.
- Traditional pacemaker implantation techniques can pose challenges in neonates and infants due to their small size and unique anatomy.
Purpose of the Study:
- To evaluate the safety and efficacy of a novel, single midline approach for permanent pacemaker implantation in children.
- To assess the feasibility of this technique in a pediatric population, including neonates and infants.
Main Methods:
- A cohort of 12 children underwent permanent pacemaker implantation using a single midline incision.
- Epicardial leads and pacemaker generators were implanted via an intermuscular abdominal approach.
- Platinized, porous-tipped, steroid-eluting epicardial leads were employed in all cases.
Main Results:
- The described technique was successfully implemented in all 12 pediatric patients.
- No early postoperative complications were recorded.
- Pacemaker function was optimal following implantation.
Conclusions:
- The single midline approach for permanent pacemaker implantation is a rapid, simple, and safe method for pediatric patients.
- This technique is particularly advantageous for neonates and infants requiring pacemaker implantation.
- The use of specialized epicardial leads contributed to successful outcomes.
Abstract:
Permanent pacemaker implantation was carried out in 12 children with a mean age of 1.4 years (range, 2 days to 4 years) and a mean weight of 8.6 kg (range, 2.4-13.6 kg), using a single midline approach for placement of both the epicardial lead and the pacemaker generator (intermuscular abdominal implantation). Platinized porous-tipped steroid-eluting epicardial leads were used in all patients. The pacemakers worked well, and there was no early postoperative complication. This technique was found to be rapid, simple, and safe in children, especially neonates and infants.