Ergün Servet, Kafalı Hasan Candaş, Genç Serhat Bahadır, Yildiz Okan, Güneş Mustafa, Onan İsmihan Selen, Ergül Yakup, Güzeltaş Alper, Haydin Sertaç
Department of Pediatric Cardiovascular Surgery, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, İstasyon Mahallesi İstanbul Caddesi Bezirganbahçe Mevki, 34303, Istanbul, Turkey.
Department of Pediatric Cardiology, Istanbul Saglik Bilimleri University Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey.
Pediatr Cardiol. 2020 Apr;41(4):755-763. doi: 10.1007/s00246-020-02306-1. Epub 2020 Feb 1.
We aimed to investigate the complications after epicardial pacemaker (PM) implantation in neonates and infants and their relationship with factors such as device size and patient size. Between May 2010 and July 2018, 55 patients under 1 year of age who underwent epicardial PM placement were retrospectively evaluated. PM-related complications requiring rehospitalization were determined as wound site problems requiring surgical intervention, battery pocket infection, battery pocket dehiscence without infection, PM removal, relocation of the PM system, and replacement of the PM system with another system. The patients were divided into three groups: < 3 kg, 3-5 kg and > 5 kg. Fifty-five patients underwent PM implantation, 43 (78.2%) because of postoperative atrioventricular block (AVB), 10 (18.2%) because of congenital AVB, and two (3.6%) with diagnoses of c-TGA and AVB. Five (9%) patients incurred 18 complications. No statistically significant difference was observed in complication development between the groups (p > 0.05). Single- or dual-chamber device implantation did not affect complication development (p > 0.05). Despite the role of factors such as low weight, low age, and device volume in the development of wound complications, the relationship between these factors and complications is not statistically significant. Therefore, our results are encouraging in terms of the use of dual-chamber PMs instead of single-chamber ones in heart diseases in which AV synchronization is important.
我们旨在研究新生儿和婴儿植入心外膜起搏器（PM）后的并发症及其与设备尺寸和患者体型等因素的关系。在2010年5月至2018年7月期间，对55例1岁以下接受心外膜PM植入的患者进行了回顾性评估。需要再次住院治疗的与PM相关的并发症被确定为需要手术干预的伤口部位问题、电池盒感染、无感染的电池盒裂开、PM移除、PM系统重新定位以及用另一个系统替换PM系统。患者被分为三组：<3kg、3 - 5kg和>5kg。55例患者接受了PM植入手术，43例（78.2%）因术后房室传导阻滞（AVB），10例（18.2%）因先天性AVB，2例（3.6%）诊断为完全性大动脉转位（c-TGA）和AVB。5例（9%）患者出现了18种并发症。各分组之间并发症的发生情况无统计学显著差异（p>0.05）。单腔或双腔设备植入对并发症的发生没有影响（p>0.05）。尽管低体重、低年龄和设备体积等因素在伤口并发症的发生中起作用，但这些因素与并发症之间的关系无统计学意义。因此，就AV同步很重要的心脏病而言，我们的结果对于使用双腔PM而非单腔PM是令人鼓舞的。
