HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Gerald M. Lawrie George C. Morris, Jr. Michael E. DeBakey Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lawrie, G. M. Articles by DeBakey, M. E. Search for Related Content PubMed PubMed Citation Articles by Lawrie, G. M. Articles by DeBakey, M. E.

Ann Thorac Surg 1979;28:561-567
© 1979 The Society of Thoracic Surgeons

---

Articles

Results of Epicardial Pacing by the Left Subcostal Approach

From the Department of Surgery, Baylor College of Medicine, Houston, TX.

^* Address reprint requests to Dr. Lawrie, Department of Surgery, Baylor College of Medicine, 1200 Moursund, Houston, TX 77030.

We have determined the clinical course of 200 consecutive patients (mean age, 67.5 years) in whom epicardial pacing was established by the left subcostal route by insertion of 2 sutureless myocardial electrodes and a demand bipolar generator.

There was 1 intraoperative death (0.5%). The overall 30-day perioperative mortality was 4 of 200 patients (2.0%). The principal postoperative complications included postpericardiotomy syndrome in 8 patients (4.0%), pneumonia or marked atelectasis in 2 patients (1.0%), and pulmonary embolus in 1 patient. Hemiplegia developed in 2 patients at 9 and 10 days, respectively, after operation, and transient monoparesis developed in another patient (1.5%). There were no wound infections, but the one wound dehiscence required resuturing. Follow-up has been completed in all patients from 1 to 39 months postoperatively (mean, 14.9 months). There have been 21 late deaths.

Late lead thresholds were recorded for 45 individual leads from 26 patients up to 35 months after operation. The results obtained indicate that for patients undergoing primary implantation, the sutureless myocardial electrode provides reliable lead function. However, patients who required reoperation because of previous pacemaker failure due to threshold rise have done poorly as a group and may be better managed with lithium high-output pacemaker generators.

This article has been cited by other articles:

				I. Zeltser, L. A. Rhodes, R. E. Tanel, V. L. Vetter, J. W. Gaynor, T. L. Spray, and M. I. Cohen Postpericardiotomy Syndrome After Permanent Pacemaker Implantation in Children and Young Adults Ann. Thorac. Surg., November 1, 2004; 78(5): 1684 - 1687. [Abstract] [Full Text] [PDF]

				K. G. Warner, D. P. Halpin, C. I. Berul, and D. D. Payne Placement of a permanent epicardial pacemaker in children using a subcostal approach Ann. Thorac. Surg., July 1, 1999; 68(1): 173 - 175. [Abstract] [Full Text] [PDF]

				G. R. Westerman, J. Baker, W. T. Dungan, and S. H. Van Devanter Permanent Pacing through a Persistent Left Superior Vena Cava: An Approach and Report of Dual-Chambered Lead Placement Ann. Thorac. Surg., February 1, 1985; 39(2): 174 - 176. [Abstract] [PDF]

				D. S. Starr, G. M. Lawrie, and G. C. Morris Jr. Acute and Chronic Stimulation Thresholds of Intramyocardial Screw-in Pacemaker Electrodes Ann. Thorac. Surg., April 1, 1981; 31(4): 334 - 338. [Abstract] [PDF]