Implantation of a permanent pacemaker through the coronary sinus in a patient who underwent mechanical valve replacement for infective endocarditis with a complete atrioventricular block.
10.12701/yujm.2014.31.2.113
- Author:
Kwan Hoon JO
1
;
Inho KIM
;
Soe Hee ANN
;
Yong Seog OH
Author Information
1. Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. oys@catholic.ac.kr
- Publication Type:Case Report
- Keywords:
Infective endocarditis;
Heart block;
Artificial cardiac pacemaker;
Coronary sinus;
Cardiac valve prosthesis
- MeSH:
Abscess;
Ambulatory Care Facilities;
Anti-Bacterial Agents;
Aortic Valve;
Aortic Valve Insufficiency;
Atrioventricular Block*;
Coronary Sinus*;
Debridement;
Electrocardiography;
Endocarditis*;
Fever;
Heart Atria;
Heart Block;
Heart Valve Prosthesis;
Humans;
Middle Aged;
Mitral Valve;
Myalgia;
Pacemaker, Artificial;
Tricuspid Valve;
Vital Signs
- From:Yeungnam University Journal of Medicine
2014;31(2):113-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 52-year-old man was referred to our hospital due to fever and myalgia that occurred 2 weeks earlier. He showed a complete atrioventricular block on his electrocardiogram, and his vital signs were unstable. On his transthoracic echocardiograph, the 1.5 cm vegetation in the aortic valve with severe aortic regurgitation suggested infective endocarditis. His transesophageal enchocardiograph showed abscess in his mitral-aortic intervalvular fibrosa and vegetation was suspected on his anterior mitral valve leaflet. The patient underwent an emergent operation for valve replacement with temporary epicardial pacing. Intraoperatively, the septal leaflet of his tricuspid valve was injured during the debridement of the abscess pocket that was extended to the membranous septum. The aortic, mitral, and tricuspid mechanical valves were replaced with annular reconstruction without complications. After 14 days of intravenous antibiotics, we successfully changed the epicardial pacemaker into a transvenous DDD-type permanent pacemaker by placing a left ventricular lead via the coronary sinus and an atrial lead in the right atrium appendage. The patient was discharged in a tolerable state and was examined uneventfully in our hospital's outpatient clinic for 8 months.
