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

This Article Alert me when this article is cited Alert me if a correction is posted 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 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.

The Annals of Thoracic Surgery, Vol 28, 561-567, Copyright © 1979 by The Society of Thoracic Surgeons

ARTICLES

Results of epicardial pacing by the left subcostal approach

GM Lawrie, JP Seale, GC Morris Jr, JF Howell, HH Whisennand and ME DeBakey

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]