INTRODUCTION: Late systemic right ventricular (RV) dysfunction after atrial redirection surgery is common. Patients may require cardiac transplantation in early adulthood. METHODS: We undertook cardiac resynchronisation (CRT)/defibrillator therapy in two patients as a bridge to transplantation. RESULTS: Two males (aged 24, 110 kg and 26 years, 106 kg); having undergone a Mustard procedure for dextro-transposition of the great arteries at 7 and 6 months of age respectively, presented with impaired systemic RV function and New York Heart Association III symptoms. Both patients had dual chamber pacemakers in-situ for sinus bradycardia. Upgrade to CRT was performed by conserving the existing endocardial leads and placement of epicardial electrodes. One demonstrated sustained improvement over a 24 month follow-up period. CONCLUSION: A hybrid CRT strategy is feasible in patients with failing systemic RVs and pre-existent endocardial dual chamber pacemakers. Appropriate patient selection criteria and optimum lead placement, however, still needs further evaluation in this population.
INTRODUCTION: Late systemic right ventricular (RV) dysfunction after atrial redirection surgery is common. Patients may require cardiac transplantation in early adulthood. METHODS: We undertook cardiac resynchronisation (CRT)/defibrillator therapy in two patients as a bridge to transplantation. RESULTS: Two males (aged 24, 110 kg and 26 years, 106 kg); having undergone a Mustard procedure for dextro-transposition of the great arteries at 7 and 6 months of age respectively, presented with impaired systemic RV function and New York Heart Association III symptoms. Both patients had dual chamber pacemakers in-situ for sinus bradycardia. Upgrade to CRT was performed by conserving the existing endocardial leads and placement of epicardial electrodes. One demonstrated sustained improvement over a 24 month follow-up period. CONCLUSION: A hybrid CRT strategy is feasible in patients with failing systemic RVs and pre-existent endocardial dual chamber pacemakers. Appropriate patient selection criteria and optimum lead placement, however, still needs further evaluation in this population.
Authors: Anne M Dubin; Jan Janousek; Edward Rhee; Margaret J Strieper; Frank Cecchin; Ian H Law; Kevin M Shannon; Joel Temple; Eric Rosenthal; Frank J Zimmerman; Andrew Davis; Peter P Karpawich; Amin Al Ahmad; Victoria L Vetter; Naomi J Kertesz; Maully Shah; Christopher Snyder; Elizabeth Stephenson; Mathias Emmel; Shubhayan Sanatani; Ronald Kanter; Anjan Batra; Kathryn K Collins Journal: J Am Coll Cardiol Date: 2005-12-20 Impact factor: 24.094
Authors: F Guarracino; C Cariello; A Danella; L Doroni; F Lapolla; C Vullo; C Pasquini; M Stefani Journal: Minerva Anestesiol Date: 2005-06 Impact factor: 3.051
Authors: Pierluigi Politi; Marco Piccinelli; Paolo Fusar-Poli; Paolo Fusar Poli; Catherine Klersy; Carlo Campana; Claudio Goggi; Mario Viganò; Francesco Barale Journal: Transplantation Date: 2004-07-27 Impact factor: 4.939