Abstract
This is the case of a middle-aged woman with Ebstein anomaly, who had a tricuspid valve replacement with a mechanic Starr-Edwards caged-ball valve many years ago, and needed an implantable cardioverter defibrillator (ICD) and ventricular pacing due to ventricular tachycardia and atrioventricular block with syncope. Furthermore, she has a chronic respiratory disease that make open chest surgery inadvisable. Prosthetic valves are a real obstacle to cross them and place catheters in the distal chamber. This report shows a technique to get access to the right ventricle endocardium through the annulus and placing the ICD electrode with correct sensing and pacing.
Highlights
This is the case of a 59-year-old woman with Ebstein anomaly who had a tricuspid valve replacement with a mechanic Starr-Edwards caged-ball valve in 1975
The electrophysiologic study was done from the left via retroaortic way and showed a supraventricular irregular rhythm, with frequent episodes of bradycardia, prolonged His ventricle interval 88 ms and spontaneous events of AV block
Since the patient has an Ebstein anomaly, the true annulus is not easy to define. Another anatomic reference was obtained contrasting the coronary sinus using the venous phase by left coronary artery injection (Fig. 1)
Summary
This is the case of a 59-year-old woman with Ebstein anomaly who had a tricuspid valve replacement with a mechanic Starr-Edwards caged-ball valve in 1975. She had several episodes of syncope, some of them with paroxysmal atrioventricular (AV ) block and, in Holter monitoring, nonsustained ventricular tachycardia was seen. Her ejection fraction was 44% and coronary disease was not seen in the coronariography. Since the patient has an Ebstein anomaly, the true annulus is not easy to define Another anatomic reference was obtained contrasting the coronary sinus using the venous phase by left coronary artery injection (Fig. 1). No complications were seen neither in the procedure nor within 6 and 12 months of follow up, there were no leaks or valve disfunction
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
