Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report.

Wang, Gebang; Yu, Zhanwu; Zhang, Chenlei; Zang, Hongyun; Monti, Lorenzo; Jeong, Jin Yong; Schmid, Ralph A.; Pilegaard, Hans K; Liu, Hongxu (2020). Pectus excavatum requiring temporary pacemaker implantation before Nuss procedure: a case report. Journal of thoracic disease, 12(9), pp. 4985-4990. AME Publishing Company 10.21037/jtd-20-2312

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Pectus excavatum is the most common chest wall deformity, and some patients also have it combined with cardiac arrhythmias. It is a rare occurrence for there to be a severe conduction block that requires a temporary pacemaker implantation before the surgical correction. Here we reported a case of pectus excavatum with a second-degree atrial-ventricular (AV) block (Mobitz II) who had temporary pacemaker implantation before the Nuss procedure. The young patient had a chest wall deformity for 6 years and it got worse with age. The Haller index was 4.21, and we evaluated that he should receive the Nuss procedure. An AV block was found during the preoperative electrocardiogram examination; furthermore, Holter monitor proved that he had first-degree AV block and a second-degree AV block (Mobitz II). After consultation with the anesthesiologist and cardiologist, we suggested that a temporary pacemaker placement should be performed under local anesthesia before the minimally invasive operation and removed as soon as the patient revived from general anesthesia. A postoperative Holter monitor was implemented, and the conduction defect disappeared shortly after the operation. However, the Holter monitor showed that the conduction defect was still existed during the follow-up period, which indicated that severe conduction defects should be originated from the conduction system itself, rather than the compression to the heart. The temporary pacemaker was essential to ensure the conducting of the operation went smoothly.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Thoraxchirurgie

UniBE Contributor:

Schmid, Ralph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2077-6624

Publisher:

AME Publishing Company

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

05 Jan 2021 14:35

Last Modified:

05 Jan 2021 14:43

Publisher DOI:

10.21037/jtd-20-2312

PubMed ID:

33145072

Uncontrolled Keywords:

Nuss procedure Pectus excavatum second-degree atrial-ventricular block temporary pacemaker implantation

BORIS DOI:

10.48350/150028

URI:

https://boris.unibe.ch/id/eprint/150028

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