Journal Article

Implantation of systems for cardiac resynchronisation: tips and tricks – cardiac surgeon's view

Bert Hansky, Sebastian Schulte-Eistrup, Juergen Vogt, Holger Gueldner, Kazutomo Minami, Dieter Horstkotte and Reiner Körfer

in European Heart Journal Supplements

Published on behalf of European Society of Cardiology

Volume 6, issue suppl_D, pages D53-D56
Published in print August 2004 | ISSN: 1520-765X
Published online August 2004 | e-ISSN: 1554-2815 | DOI: http://dx.doi.org/10.1016/j.ehjsup.2004.05.014
Implantation of systems for cardiac resynchronisation: tips and tricks – cardiac surgeon's view

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Specific problems of cardiosurgical implantation of biventricular devices for cardiac resynchronisation therapy are elucidated elaborately. In particular, the necessity and amount of intraoperative monitoring as well as the appropriate mode of anaesthesia are described. Furthermore, the sequence of lead placement, the technique of coronary sinus intubation using a guiding catheter as well as means to avoid thrombus formation in the coronary sinus are depicted.

Biventricular ICD devices should be implanted from a left sided approach to integrate the device into the defibrillation field and to maintain the option of placing an additional subcutaneous array lead.

It is of particular cardiosurgical interest that coronary vein leads are applicable for ventricular stimulation in patients after tricuspid valve replacement thus avoiding repeated surgical exposure of the heart.

Keywords: Cardiac resynchronisation therapy; Biventricular ICD; Surgical technique; Tricuspid valve replacement

Journal Article.  1796 words.  Illustrated.

Subjects: Cardiovascular Medicine

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