title: Prevalence of venous obstruction in permanent endovenous pacing in newborns and infants: follow-up study.
abstract: OBJECTIVE
  We examined the prevalence of venous obstruction in 12 newborns and infants with permanent endovenous ventricular pacing, clinically, and by ultrasonographic assessment of hemodynamics (spontaneity, phasicity, velocity, and turbulence of flow) and morphologic parameters (compressibility, wall thickness, and thrombus presence).
  
  
  METHODS
  All implantations of single ventricular unipolar endovenous steroid leads, were performed via cephalic vein, and pacemakers were placed in subcutaneous pocket in right prepectoral region. After the vascular surgeon has carefully examined all children for presence of venous collaterals in the chest wall, morphologic and hemodynamic parameters of the subclavian, axillary, and internal jugular veins, were assessed by linear-array color Doppler. Lead capacity (LC) was calculated for each patient.
  
  
  RESULTS
  Mean age of patients at implant was 6.2 months (range 1 day-12 months), mean weight 6.5 kg (range 2.25-10 kg), and mean height 60.9 cm (range 48-78 cm). Mean LC was 1.99 (range 1.14-3.07). Total follow-up was 1023 and mean follow-up 85.2 pacing months (range 3-156). No clinical signs of venous obstruction were observed. Mild stenosis (20%) of subclavian vein was found by color Doppler in 2/12 patients. Both had adequate lead diameter for body surface.
  
  
  CONCLUSIONS
  Permanent endovenous pacing is a feasible procedure, even in children of body weight less than 10 kg, with quite acceptable impact on venous system patency.
authors.affiliation: Institute for Cardiovascular Diseases, UC Clinical Centre of Serbia, Belgrade, Serbia and Montenegro. st.petar@eunet.yu
authors.forename: Petar
authors.initials: P
authors.lastname: Stojanov
authors.forename: Mile
authors.initials: M
authors.lastname: Vranes
authors.forename: Dusan
authors.initials: D
authors.lastname: Velimirovic
authors.forename: Mirjana
authors.initials: M
authors.lastname: Zivkovic
authors.forename: Mladen J
authors.initials: MJ
authors.lastname: Kocica
authors.forename: Lazar
authors.initials: L
authors.lastname: Davidovic
authors.forename: Voislava
authors.initials: V
authors.lastname: Neskovic
authors.forename: Mila
authors.initials: M
authors.lastname: Stajevic
mesh_terms: D000293:Adolescent; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*