Abstract
BackgroundPacemaker implantation techniques using thoracoscopy have been described since about 25 years. However, the published reports concerning types of electrodes refer mostly to monopolar screw-in leads. We report our experience of thoracoscopic implantation of a bipolar suture-on epicardial electrode with monofilamentous sutures tightened by automated fasteners to avoid hand-tied knots.Case presentationA 69-year-old Caucasian female patient with a cardiac resynchronization therapy – defibrillator (CRT-D) due to dilated cardiomyopathy required the implantation of a supplementary left ventricluar resynchronization electrode. Because of unfavorable venous access, we chose a thoracoscopic approach. A bipolar suture-on epicardial electrode, was implanted by means of polypropylene monofilament 2–0 threads and automated titanium fasteners (Cor-Knot®). The intervention was uneventful. The correct function of the device was confirmed postoperatively and the patient was dismissed within 3 days from hospital. Six months after implantation the cardiologic control asserted regular device function and restitution of normal ejection fraction (EF 60%).ConclusionThis case demonstrates the feasibility, safety and effectiveness of automated fasteners in the setting of thoracoscopic implantation of epicardial bipolar suture-on leads.
Highlights
Pacemaker implantation techniques using thoracoscopy have been described since about 25 years
We report our experience of thoracoscopically implanting a bipolar suture-on epicardial electrode with monofilamentous sutures tightened with automated fasteners to avoid hand-tied knots
* Correspondence: thibaultsch@hotmail.com; thibault.schaeffer@usb.ch 1Department of cardiac surgery, University Hospital of Basel, Spitalstrasse 31, CH 4031 Basel, Switzerland Full list of author information is available at the end of the article
Summary
Pacemaker implantation techniques using thoracoscopy have been described since about 25 years. Background The implantation of cardiac resynchronization therapy (CRT) leads for the management of cardiac dyssynchrony is generally performed percutaneously via the coronary sinus or a left cardiac vein. An epicardial electrode can be fixed on the free wall of the left ventricle. We report our experience of thoracoscopically implanting a bipolar suture-on epicardial electrode with monofilamentous sutures tightened with automated fasteners to avoid hand-tied knots.
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