Experience with a simple method of epicardialintramural pacer lead implantation on either ventricle using local anaesthesia for long term cardiac pacing in casesof symptomatic heart block ispresented. The report concerns 40 patients with 41 implants. The follow-up period was 6-19 months. There were 3 operative deaths. One ofthe deaths was coincidental and the other 2 were attributed to bad selection. Early electrode failure due to the development of an exit block occurred in 1 case; he has done well after his right ventricular electrode was transferred to the left ventricle through the same incision using local anaesthesia. There has been no late electrode failure. Nearly all the survivors have obtained excellent results. The distinct advantages offered by this technique of epicardial pacing are discussed. The mod$cation which has been introduced in extending the scope of pacer lead implantation to the left ventricle has increased the usefulness of the technique. Left ventricular placement of the electrode assures better intramural pacing.
Case report: A 25 year old male underwvent emergency excision of a left atrial (LA) mass with an echocardiographic diagnosis of LA myxoma with left ventricular inflow obstruction. Mass was broad based, attached to LA roof and was excised totally through right atrial approach. Histopathological examination revealed myxosarcoma. He had an uneventful recovery and was discharged on the 6th postoperative day. He received adjuvant chemotherapy at the Regional Cancer Centre. Patient is on follow up and is free from recurrence till the 8th month.Conclusions: Myxosarcoma is an extremely rare tumour. Complete resection of the tumour and adjuvant chemotherapy is the mainstay of treatment.
Clinical experience and surgical considerations in [----] the management of cardiac myxomas
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