Minimally Invasive Thoracoscopic Technique for LV Lead Implantation in CRT Patients

Droghetti, Andrea; Branzoli, Stefano; Moggio, Paolo; Belotti, Giuseppina; Valsecchi, Sergio; Coser, Alessio; Guarracini, Fabrizio; Quintarelli, Silvia; Pederzolli, Carlo; Graffigna, Angelo; Bonmassari, Roberto; Pomarolli, Claudio; Molon, Giulio; Bottoli, Maria Caterina; Centonze, Maurizio; Campari, Monica; Marini, Massimiliano

doi:10.4172/2155-9880.1000575

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…The technique has been previously described . In summary, after a general anesthetic had been administered, a double‐lumen endotracheal tube was inserted.…”

Section: Methodsmentioning

confidence: 99%

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Epicardial left ventricular lead implantation in cardiac resynchronization therapy patients via a video‐assisted thoracoscopic technique: Long‐term outcome

Marini

Branzoli

Moggio

et al. 2019

Clinical Cardiology

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Background Epicardial placement of the left ventricular (LV) lead via a video‐assisted thoracoscopic (VAT) approach is an alternative to the standard transvenous technique. Hypothesis Long‐term safety and efficacy of VAT and transvenous LV lead implantation are comparable. To test it, we reviewed our experience and we compared the outcomes of patients who underwent implantation with the two techniques. Methods The VAT procedure is performed under general anesthesia, with oro‐tracheal intubation and right‐sided ventilation, and requires two 5 mm and one 15 mm thoracoscopic ports. After pericardiotomy at the spot of the epicardial target area, pacing measurements are taken and a spiral screw electrode is anchored at the final pacing site. The electrode is then tunneled to the pectoral pocket and connected to the device. Results 105 patients were referred to our center for epicardial LV lead implantation. After pre‐operative assessment, 5 patients were excluded because of concomitant conditions precluding surgery. The remaining 100 underwent the procedure. LV lead implantation was successful in all patients (median pacing threshold 0.8 ± 0.5 V, no phrenic nerve stimulation) and cardiac resynchronization therapy was established in all but one patient. The median procedure time was 75 min. During a median follow‐up of 24 months, there were no differences in terms of death, cardiovascular hospitalizations or device‐related complications vs the group of 100 patients who had undergone transvenous implantation. Patients of both groups displayed similar improvements in terms of ventricular reverse remodeling and functional status. Conclusions Our VAT approach proved safe and effective, and is a viable alternative in the case of failed transvenous LV implantation.

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“…The technique has been previously described . In summary, after a general anesthetic had been administered, a double‐lumen endotracheal tube was inserted.…”

Section: Methodsmentioning

confidence: 99%

“…The technique has been previously described. 1 In summary, after a general anesthetic had been administered, a double-lumen endotracheal tube was inserted. With the patient in a right lateral decubitus position (90 ) and on single-lung ventilation, three ports (2 × 5 mm;…”

Section: Surgical Technique and Approachmentioning

confidence: 99%

Epicardial left ventricular lead implantation in cardiac resynchronization therapy patients via a video‐assisted thoracoscopic technique: Long‐term outcome

Marini

Branzoli

Moggio

et al. 2019

Clinical Cardiology

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“…Beneficial effect of CRT-D in selected patients with ischemic HF has been demonstrated, however optimal LV lead position is paramount [1]. Thoracoscopic placement of the LV lead for CRT is a valuable option when transvenous implantation is impossible [2,3]. The use of deflectable implantation tool greatly improves access to the target area on the LV wall.…”

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confidence: 99%

Combined procedure involving thoracoscopic implantation of the epicardial left ventricular lead and removal of the His bundle pacing lead in a patient with heart failure

Bis¹,

Gościńska-Bis²,

Gardas³

et al. 2020

Kardiol Pol

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Minimally Invasive Thoracoscopic Technique for LV Lead Implantation in CRT Patients

Cited by 2 publications

References 17 publications

Epicardial left ventricular lead implantation in cardiac resynchronization therapy patients via a video‐assisted thoracoscopic technique: Long‐term outcome

Epicardial left ventricular lead implantation in cardiac resynchronization therapy patients via a video‐assisted thoracoscopic technique: Long‐term outcome

Combined procedure involving thoracoscopic implantation of the epicardial left ventricular lead and removal of the His bundle pacing lead in a patient with heart failure

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