摘要
Transvenous endocardial pacemaker (PM) implantation is contraindicated in patients with a mechanical tricuspid prosthesis. These patients usually undergo epicardial lead implantation. This case shows the implant of left ventricular (LV) pacing lead through the coronary sinus (CS) in a patient with high surgical risk. A 77-year-old woman with slow atrial fibrillation, left anterior hemi-block and right bundle brunch block, who previously underwent surgical replacement of the mitral and tricuspid valves, was admitted for PM implantation. After 1 month, all the electric parameters were stable. To the best of our knowledge, this is the first Italian case reported of LV pacing in a patient with a mechanical tricuspid prosthesis. The use of LV pacing leads implanted through the CS provides a minimal invasive, safe and effective strategy of pacing in patients with a mechanical tricuspid prosthesis.
Transvenous endocardial pacemaker (PM) implantation is contraindicated in patients with a mechanical tricuspid prosthesis. These patients usually undergo epicardial lead implantation. This case shows the implant of left ventricular (LV) pacing lead through the coronary sinus (CS) in a patient with high surgical risk. A 77-year-old woman with slow atrial fibrillation, left anterior hemi-block and right bundle brunch block, who previously underwent surgical replacement of the mitral and tricuspid valves, was admitted for PM implantation. After 1 month, all the electric parameters were stable. To the best of our knowledge, this is the first Italian case reported of LV pacing in a patient with a mechanical tricuspid prosthesis. The use of LV pacing leads implanted through the CS provides a minimal invasive, safe and effective strategy of pacing in patients with a mechanical tricuspid prosthesis.
