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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Urgent permanent pacemaker implantation in critically ill preterm infants
Elizabeth M Welch1, Robert L Hannan, William M DeCampli
1Department of Cardiology, Miami Children's Hospital, Miami, Florida 33155, USA. drlizlloyd@aol.com
The Annals of Thoracic Surgery
|July 9, 2010
Summary
Emergent pacemaker implantation in premature infants with complete heart block is feasible. This intervention can be life-saving for very low birth-weight neonates, including those with hydrops fetalis.
Area of Science:
- Neonatal cardiology
- Pediatric electrophysiology
- Congenital heart disease
Background:
- Complete heart block in premature infants presents significant management challenges.
- Hydrops fetalis complicates the prognosis and treatment of neonatal complete heart block.
- Low birth weight (<2500g) in neonates with complete heart block requires specialized care.
Observation:
- Two premature infants, one with hydrops fetalis, experienced complete heart block.
- Birth weights were 1,400 grams and 1,000 grams, indicating very low birth weight.
- Emergent implantation of permanent epicardial pacemakers was performed within 48 hours of life.
Findings:
- Successful emergent implantation of permanent epicardial pacemakers in extremely premature infants.
- Pacemaker implantation was technically feasible and achieved in the early neonatal period.
- This approach addresses life-threatening bradycardia in this vulnerable population.
Implications:
- Early pacemaker implantation can be a viable strategy for managing complete heart block in extremely low birth-weight infants.
- This case series suggests that permanent epicardial pacing can be safely performed in neonates, even with hydrops fetalis.
- Further research is warranted to establish long-term outcomes and optimize management protocols for neonatal complete heart block.
