Surgical Placement of Permanent Epicardial Pacing Systems in Very Low-Birth Weight Premature Neonates: A Review of Data From the Pediatric Cardiac Care Consortium (PCCC)

Charles W. Shepard, Lazaros Kochilas, Jeffrey M. Vinocur, Roosevelt Bryant, Brian A. Harvey, Scott Bradley, William Decampli, James D. St. Louis

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Few studies have characterized the surgical outcomes following epicardial pacemaker placement in very low-birth weight infants with congenital complete heart block. This study was undertaken to review the surgical experience with this patient population based on data from a large multi-institutional registry. Methods: The Pediatric Cardiac Care Consortium (PCCC) multi-institutional database was retrospectively reviewed to identify premature, low-birth weight neonates that underwent surgical placement of an epicardial pacing system for heart block. We reviewed 179 patients with birth weights less than 1.5 kg that underwent a major operative procedure. Of these, 10 patients underwent surgical placement of an epicardial pacing system for heart block. Patients had heart block in otherwise structurally normal hearts (n = 6) or heart block associated with complex structural congenital cardiac anomalies (n = 4). Results: There were no deaths directly related to the surgical placement of the epicardial pacing system. There were no immediate complications with either lead or generator placement. One generator pocket was revised three months following placement. Survival to discharge was 60%. The four deaths occurred at a mean of 11 days (range 1-45 days) following the procedure. Conclusions: Neonates born with prematurity and congenital heart block represent a challenging subset of patients with significant mortality. Generator pocket breakdown and infection have been considered barriers to optimal short- and long-term outcomes. Among cases in the PCCC, there were no deaths or major complications that could be attributed to permanent epicardial pacemaker placement. These data suggest that an aggressive surgical strategy may be justified.

Original languageEnglish (US)
Pages (from-to)454-458
Number of pages5
JournalWorld Journal for Pediatric and Congenital Heart Surgery
Volume3
Issue number4
DOIs
StatePublished - Oct 2012
Externally publishedYes

Keywords

  • complications
  • congenital heart surgery
  • pacemaker
  • pacing complications

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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