Hofmann, Hans-Stefan and Ried, Michael and Sziklavari, Zsolt (2014) Minimally invasive epicardial left ventricular lead placement in a case of massive pleural adhesion. JOURNAL OF CARDIOTHORACIC SURGERY, 9: 70. ISSN 1749-8090,
Full text not available from this repository. (Request a copy)Abstract
Background: In cases of intravenous placement failure of the left ventricular (LV) lead for cardiac resynchronisation therapy (CRT) and obliteration of the left pleural space, the alternative approach of transthoracic placement by video-assisted thoracoscopic surgery (VATS) is difficult and not commonly practiced. Methods: Here, we present a simple technique for transthoracic introduction of an epicardial LV lead using a wound retractor (ALEXIS (R)) in a patient with heart failure. This wound retractor enables atraumatic tissue retraction without rib spreading, an optimal direct view in the pleural space for surgical pleurolysis and a high degree of safety for the patient. Results: No perioperative complications occurred. The tube drainage was removed on the second postoperative day, and the patient was discharged on the third postoperative day. Conclusions: The decided advantage of this new method is the lack of any need for rib spreading using a mechanical retractor. Especially in patients with a history of open-heart surgery (including internal mammary artery bypass grafting and/or revascularisation of the left lateral wall) or known pleural adhesions (e.g., pleuritis or lung operations), the described technique provides a rapid and save access with minimal surgical effort and greater safety.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | VACUUM-ASSISTED CLOSURE; IMPLANTATION; EMPYEMA; Wound retractor; Left ventricular (LV) lead implantation; Video-assisted thoracoscopic surgery; Cardiac resynchronisation therapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Thoraxchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Nov 2019 10:05 |
| Last Modified: | 14 Nov 2019 10:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/10315 |
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