Transvenous pacing after the Mustard procedure: considering the complications

Area of Science:

• Cardiology
• Cardiac Surgery
• Electrophysiology

Background:

• Transposition of the great arteries (TGA) is a congenital heart defect requiring surgical correction.
• Patients with TGA are at increased risk for developing arrhythmias and conduction abnormalities.
• Sick sinus syndrome and atrioventricular conduction disturbances are common sequelae requiring pacemaker implantation.

Purpose of the Study:

• To present a case of a patient with corrected TGA who required a permanent pacemaker.
• To review potential complications associated with transvenous pacemaker implantation in TGA patients.
• To emphasize the importance of monitoring cardiac rhythm and conduction in post-TGA surgical patients.

Main Methods:

• Case report of a 29-year-old male with corrected TGA (Mustard procedure).
• Patient presented with progressive atrioventricular conduction disturbances and sinus node dysfunction.
• Review of literature concerning pacemaker implantation and its complications in TGA patients.

Main Results:

• The patient successfully received a permanent pacemaker for symptomatic bradycardia.
• Literature review identified potential complications including lead dislodgement, infection, and device malfunction.
• Transvenous pacemaker implantation in TGA patients carries specific risks that need careful management.

Conclusions:

• Permanent pacemaker implantation is a necessary intervention for some patients with corrected TGA experiencing significant arrhythmias.
• Careful patient selection and procedural technique are crucial to minimize complications.
• Long-term follow-up is essential for managing pacemaker-dependent patients with a history of TGA.