Prevalence of venous obstruction in permanent endovenous pacing in newborns and infants: follow-up study.
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.
Stojanov
Petar
P
Institute for Cardiovascular Diseases, UC Clinical Centre of Serbia, Belgrade, Serbia and Montenegro. st.petar@eunet.yu
Vranes
Mile
M
Velimirovic
Dusan
D
Zivkovic
Mirjana
M
Kocica
Mladen J
MJ
Davidovic
Lazar
L
Neskovic
Voislava
V
Stajevic
Mila
M
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*