A challenging pacemaker implantation in the presence of a giant right coronary aneurysm compressing the right atrium

Monaldi Archives for Chest Disease

Stefano Maffè¹  Franchetti Pardo Nicolò¹  Dellavesa Pierfranco¹  Luca Bergamasco¹  Giulia Careri¹  EmanuelaFacchini¹  Eleonora Prenna¹  Paola Paffoni¹  Lara Baduena¹ 

[1] Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara;

关键词: Pacemaker implantation;    Giant coronary aneurysm;    echocardiography;   

DOI  :  10.4081/monaldi.2021.2048

来源: DOAJ

【 摘 要 】

Giant coronary artery aneurysm is an uncommon disease, treated with surgical intervention or percutaneous coil embolization. A thrombosed aneurysm can cause extrinsic compression on the cardiac chambers, with potential hemodynamic effects and may cause problems when we need to implant a cardiac device. We present a case of difficult pacemaker implantation in a patient with 3 syncopes, first-degree AV block and complete left bundle branch block on electrocardiogram. The patient presented a giant aneurysm of the right coronary artery (85 x 90 mm), thrombosed, with right atrial compression. The pacemaker implantation was hampered by the difficulty of passing the lead through the compressed right atrium; indeed, only with   simultaneous echocardiographic and fluoroscopic guidance, was it possible to complete the procedure. This case demonstrates the utility of echocardiogram, in particular settings, in cardiac stimulation procedures.

【 授权许可】

Unknown