ABSTRACT
Twelve-lead ECG of a child with Wolff-Parkinson-White syndrome and systolic dysfunction was consistent with the anteroseptal accessory pathway. The earliest atrial activation during electrophysiological study was found between the right anteroseptal region near the HIS. Multiple femoral tract right-sided cryotest lesions followed by radiofrequency catheter irrigated through the jugular vein route were unsuccessful. Then, non-coronary aortic cusp mapping and cryoablation were successfully performed with a retroartic approach.
Subject(s)
Catheter Ablation , Wolff-Parkinson-White Syndrome , Humans , Child , Wolff-Parkinson-White Syndrome/surgery , Heart Atria/surgery , Electrocardiography , Aorta/surgeryABSTRACT
The procedure of stenting the patent ductus arteriosus (PDA) is a palliative procedure applied as an alternative to surgery in newborns with ductus-dependent pulmonary circulation. However, it is still a very challenging method in patients with aortic arch anomalies. We describe our experience with a newborn with right atrial isomerism and dextrocardia, complete atrioventricular septal defect, aortic outlet right ventricle with pulmonary atresia, right aortic arch, and a PDA from the left innominate artery. Because the PDA was long and tortuous, we preferred placing three short stents instead of a single long stent. The procedure applied the femoral artery approach with a Glidesheath Slender to decrease arterial injuries. PDA stenting in challenging morphologies can be performed successfully using multiple short stents and via Glidesheath Slenders.
Subject(s)
Dextrocardia/diagnosis , Ductus Arteriosus, Patent/diagnosis , Heart Septal Defects/diagnosis , Pulmonary Atresia/diagnosis , Stents , Computed Tomography Angiography , Dextrocardia/complications , Dextrocardia/diagnostic imaging , Dextrocardia/surgery , Diagnosis, Differential , Ductus Arteriosus, Patent/complications , Ductus Arteriosus, Patent/diagnostic imaging , Ductus Arteriosus, Patent/surgery , Female , Heart Septal Defects/complications , Heart Septal Defects/diagnostic imaging , Heart Septal Defects/surgery , Humans , Infant, Newborn , Pulmonary Atresia/complications , Pulmonary Atresia/diagnostic imaging , Pulmonary Atresia/surgeryABSTRACT
Cardiac pacemakers have improved patient survival and quality of life, although malfunctions can be seen. We present the case of a girl with Seckel syndrome and congenital complete heart block. She had a single chamber permanent pacemaker in the right ventricle. When she referred us with a pulmonary hypertensive crisis (PHC), it was seen that the device was not pacing even in maximum threshold and pulse width values. After new epicardial lead implantation into the left ventricular apex, capture could be established again. For the cases presenting with capture failure, after eliminating lead-related problems and biochemical abnormalities, PHC should be kept in mind as a reason.
