Abstract
External pacemakers (PM) via temporary epicardial leads are routinely applied to infants
and children during heart surgery, which usually, after an uneventful post surgical
course, can be removed without complications. We report about two infants with complex
congenital heart defects after cardiac surgery (arterial switch and Mustard operation
for Transposition of the great arteries). Intraoperative these patients received temporary
epicardial PM wires. Thirteen and 18 days post surgery, respectively, the PM wires
were removed under electrocardiogram (ECG) monitoring. The patients showed acute ECG
changes in terms of significant ST elevation during and after removing their pacing
wires. Clinically, patients were stable and subsequent echocardiographic examination
showed no evidence of myocardial dysfunction or pericardial effusion. In the course
of time, patients showed no signs of arrhythmia or abnormal ECG changes. The decision
to place temporary pacing wires during the cardiac surgery in patients with congenital
heart defects should be considered carefully and their removal should occur under
ECG monitoring as soon as the situation of the patient allows. It should be taken
into consideration that a complication like this case may be related to delayed removal
of temporary PM's leads.
Keywords
Congenital heart disease - pacemaker - vascular tone and reactivity - arrhythmia
