open access

Vol 17, No 5 (2010)
Case Reports
Published online: 2010-09-23
Submitted: 2013-01-14
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Resynchronization therapy transvenous approach in dextrocardia and congenitally corrected transposition of great arteries

Barbara Małecka, Jacek Bednarek, Lidia Tomkiewicz-Pająk, Piotr Klimeczek, Andrzej Ząbek, Mieczysław Pasowicz, Jacek Lelakowski
Cardiol J 2010;17(5):503-508.

open access

Vol 17, No 5 (2010)
Case Reports
Published online: 2010-09-23
Submitted: 2013-01-14

Abstract

Cardiac resynchronization therapy (CRT) is an acknowledged treatment for advanced heart failure in acquired dilated cardiomyopathy, resistant to pharmacotherapy. Although there are no therapeutic standards regarding heart failure originating from congenital heart defects with systemic right ventricle, a number of CRT implantations by transvenous approach in congenitally corrected transposition of the great arteries (CCTGA) have been reported since 2001, even though none of them expressly referred to a case concomitant with dextrocardia and situs inversus anomaly.
We present a 57 year-old patient with dextrocardia and CCTGA, who underwent surgical closure of interatrial and interventricular septal defects at the age of 19, and in whom a VVI pacemaker was subsequently implanted at age 36. A three-lead CRT system was implanted by transvenous approach. Imaging techniques, including multi-slice computed tomography, targeted to pacing system and unusual anatomical relationships were applied. Within a 20-month follow-up, a significant improvement of functional NYHA class, systemic right ventricle ejection fraction and exercise capability were observed.
Entirely transvenous CRT system implantation is feasible in patients with dextrocardia and CCTGA, and has substantial potential for long-term benefits. (Cardiol J 2010; 17, 5: 503-508)

Abstract

Cardiac resynchronization therapy (CRT) is an acknowledged treatment for advanced heart failure in acquired dilated cardiomyopathy, resistant to pharmacotherapy. Although there are no therapeutic standards regarding heart failure originating from congenital heart defects with systemic right ventricle, a number of CRT implantations by transvenous approach in congenitally corrected transposition of the great arteries (CCTGA) have been reported since 2001, even though none of them expressly referred to a case concomitant with dextrocardia and situs inversus anomaly.
We present a 57 year-old patient with dextrocardia and CCTGA, who underwent surgical closure of interatrial and interventricular septal defects at the age of 19, and in whom a VVI pacemaker was subsequently implanted at age 36. A three-lead CRT system was implanted by transvenous approach. Imaging techniques, including multi-slice computed tomography, targeted to pacing system and unusual anatomical relationships were applied. Within a 20-month follow-up, a significant improvement of functional NYHA class, systemic right ventricle ejection fraction and exercise capability were observed.
Entirely transvenous CRT system implantation is feasible in patients with dextrocardia and CCTGA, and has substantial potential for long-term benefits. (Cardiol J 2010; 17, 5: 503-508)
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Keywords

cardiac resynchronization therapy; CCTGA; transvenous approach; dextrocardia in situs viscerum inversus; multi-slice computed tomography

About this article
Title

Resynchronization therapy transvenous approach in dextrocardia and congenitally corrected transposition of great arteries

Journal

Cardiology Journal

Issue

Vol 17, No 5 (2010)

Pages

503-508

Published online

2010-09-23

Bibliographic record

Cardiol J 2010;17(5):503-508.

Keywords

cardiac resynchronization therapy
CCTGA
transvenous approach
dextrocardia in situs viscerum inversus
multi-slice computed tomography

Authors

Barbara Małecka
Jacek Bednarek
Lidia Tomkiewicz-Pająk
Piotr Klimeczek
Andrzej Ząbek
Mieczysław Pasowicz
Jacek Lelakowski

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