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Related Experiment Videos

[Cardiac strangulation with permanent epicardial pacemaker lead].

T Sugita1, Y Yokota, F Ando

  • 1Department of Cardiovascular Surgery, Hyogo Kenritsu Amagasaki Hospital.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 1, 1992
PubMed
Summary
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Permanent pacemaker leads can cause rare "cardiac strangulation" in children, compressing vital heart structures. This complication requires surgical intervention to relieve obstruction and restore normal cardiac function.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • A 3-year-old boy with tetralogy of Fallot received permanent epicardial pacemaker leads for transient complete atrioventricular block.
  • Initial postoperative recovery was uneventful, with no immediate need for generator implantation.

Observation:

  • At age nine, the patient presented with biventricular heart failure and right ventricular outflow tract obstruction (RVOTO).
  • Rapid deterioration necessitated semi-emergency surgery to address the RVOTO.

Findings:

  • Intraoperative findings revealed pacemaker leads deeply embedded in the atrioventricular groove.
  • These leads caused "cardiac strangulation," compressing the main pulmonary artery, left main coronary artery, and encircling the left ventricle.

Related Experiment Videos

  • Surgical intervention involved lead dissection and segmental cutting, along with pulmonary artery patch enlargement.

    • Implications:

    • This case highlights the rare but serious complication of "cardiac strangulation" due to permanent pacemaker leads in pediatric patients.
    • Awareness of this potential complication is crucial for managing pediatric cases requiring permanent pacemaker lead implantation.
    • Prompt surgical management can restore normal cardiac function, even in severe cases.