4:20 PM - 5:10 PM
[II-JCKO5-05] A Hybrid Biventricular CRT for a 6-year-old patient with heart failure after interventional closure of ventricular septal defect
Cardiac resynchronization therapy (CRT) is an effective treatment for adult heart failure patients with wide QRS duration (QRS≥150ms).
The positive response in adult HF prompted exploration of the use of CRT in pediatric HF patients. However, the effectiveness of CRT in the pediatric population is difficult to evaluate because of the complex anatomic substrates of congenital heart disease (CHD).
In this case, we introduce a hybrid CRT system for a 6y old girl with HF and CLBBB after an interventional closure of ventricular septal defect(VSD) 2 year before.
A 6y old girl , with the weight of 22kg, 2 years after an interventional occluding operation for perimemberous VSD was admitted into the hospital due to the progressive dyspnea and poor stamina. After a regular combined anti-HF treatment for at least 12 month, she showed a progressive decrease EF(EF=18.9%) in echocardiography and CLBBB(QRS=172ms) in ECG. .
The patient accepted CRT implantation using a hybrid way: RA and RV leads were placed through left subclavian vein and LV lead was placed epicardially, through a mini-thoracotomy and tunneled up to the prepectoral pocket by cardiac surgeon. One month follow up showed the QRS duration reduce to 142ms and EF rise to 27.8%.
Although more follow up data need to be collected, this case and the hybrid implantation of CRT may be helpful in pediatric and CHD patients.
The positive response in adult HF prompted exploration of the use of CRT in pediatric HF patients. However, the effectiveness of CRT in the pediatric population is difficult to evaluate because of the complex anatomic substrates of congenital heart disease (CHD).
In this case, we introduce a hybrid CRT system for a 6y old girl with HF and CLBBB after an interventional closure of ventricular septal defect(VSD) 2 year before.
A 6y old girl , with the weight of 22kg, 2 years after an interventional occluding operation for perimemberous VSD was admitted into the hospital due to the progressive dyspnea and poor stamina. After a regular combined anti-HF treatment for at least 12 month, she showed a progressive decrease EF(EF=18.9%) in echocardiography and CLBBB(QRS=172ms) in ECG. .
The patient accepted CRT implantation using a hybrid way: RA and RV leads were placed through left subclavian vein and LV lead was placed epicardially, through a mini-thoracotomy and tunneled up to the prepectoral pocket by cardiac surgeon. One month follow up showed the QRS duration reduce to 142ms and EF rise to 27.8%.
Although more follow up data need to be collected, this case and the hybrid implantation of CRT may be helpful in pediatric and CHD patients.