Parasternal mediastinotomy for implantation of a myocardial electrode. Experience of 71 patients.

The clinical experience of a pacemaker material of 71 petients in whom myocardial electrodes were implanted through left parasternal mediastinotomy is presented. The indication for implantation of a myocardial electrode was a complication of the transvenous electrode in 93% of the cases. Minor pulmonary/pleural complications with insignificant sequelae occurred in 18%. Wound infections accompanied by fistulisation as a late complication occurred in 4.2%. There was one (1.4%) postoperative death in hospital. Two patients died later at the end of the first postoperative month of causes not directly associated with surgery. These three patients were over 75 years of age. The material was followed up for an average of 21.5 months. The incidence of fistulisation during the follow-up period was 5.5%/patient-year. One case of breaking of the tip of the myocardial electrode was encountered during the follow-up. The mortality rate for the series was 7%/patient-year.