K G Warner1, D P Halpin, C I Berul, D D Payne. 1. Division of Cardiothoracic Surgery, New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts 02111, USA. kenneth.warner@es.nemc.org
Abstract
BACKGROUND: Previously described techniques for epicardial pacemakers in children have generally included either a left thoracotomy approach or a subxiphoid incision. METHODS: We have recently used a single left subcostal incision for placement of both the epicardial electrodes and the pacemaker generator. We report our initial experience with this technique in 8 patients. The mean age was 4 years (range, 4 months to 12 years). The smallest patient weighed 4,100 g. RESULTS: The subcostal approach was successful in 7 patients. One patient with a narrow costal margin operated on early in our experience required conversion to a thoracotomy. The pacing thresholds were uniformly excellent in all patients. There have been no associated complications. CONCLUSIONS: Placement of epicardial leads using a left subcostal incision avoids a thoracotomy, is simpler than a subxiphoid approach, and results in acceptable thresholds with minimal morbidity.
BACKGROUND: Previously described techniques for epicardial pacemakers in children have generally included either a left thoracotomy approach or a subxiphoid incision. METHODS: We have recently used a single left subcostal incision for placement of both the epicardial electrodes and the pacemaker generator. We report our initial experience with this technique in 8 patients. The mean age was 4 years (range, 4 months to 12 years). The smallest patient weighed 4,100 g. RESULTS: The subcostal approach was successful in 7 patients. One patient with a narrow costal margin operated on early in our experience required conversion to a thoracotomy. The pacing thresholds were uniformly excellent in all patients. There have been no associated complications. CONCLUSIONS: Placement of epicardial leads using a left subcostal incision avoids a thoracotomy, is simpler than a subxiphoid approach, and results in acceptable thresholds with minimal morbidity.
Authors: Elizabeth B Fortescue; Charles I Berul; Frank Cecchin; Edward P Walsh; John K Triedman; Mark E Alexander Journal: J Interv Card Electrophysiol Date: 2005-10 Impact factor: 1.900
Authors: Brian J Lichtenstein; David P Bichell; Dana M Connolly; John J Lamberti; Suzanne M Shepard; Stephen P Seslar Journal: Pediatr Cardiol Date: 2010-08-06 Impact factor: 1.655