INTRODUCTIONPacemaker implantation (PMI) is rarely required in low‐birth‐weight infants (LBWIs). However, congenital complete atrioventricular block (CCAVB) in infants with fetal bradycardia are frequently LBWIs. We performed temporary PMI (tPMI) through a subxiphoid approach, followed by permanent PMI (pPMI) using single‐chamber pacing through a left thoracotomy in three LBWIs, and report our results with this technique.SURGICAL TECHNIQUE AND MANAGEMENTThis single‐center retrospective study was approved by the Okinawa Prefectural Nanbu Medical Center & Children's Medical Center Research Integrity and Compliance Committee. The need for written informed consent was waived.In postpartum LBWIs with bradycardia, we initiate β‐stimulant therapy with continuous infusion (of isoproterenol 0.01‐0.02 μg/kg/min). In the early neonatal period, tPMI is performed through a subxiphoid approach (Figure A, black arrow). Two temporary leads with four electrodes (Osypka Heartwire TME.T bipolar 2.5 mm, Osypka AG, Rheinfelden, Germany) are sutured on the myocardium using 7‐0 polypropylene sutures at the anterior and/or inferior surface of the right ventricle, and the opposite sides of the leads are passed to the right upper abdomen through a rectus abdominis muscle tunnel. The leads should not penetrate the myocardium (Figure B). Primary pPMI was performed for all non‐LBWIs (birth weight >2.5 kg) without any complications. When the child is >2.5 kg, the
Journal of Cardiac Surgery – Wiley
Published: Jan 1, 2018
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