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J Thorac Cardiovasc Surg 2003;125:1167-1169
© 2003 The American Association for Thoracic Surgery

Brief Communications

Simultaneous biventricular pacemaker implantation for a surgical case of aortic regurgitation with severe left ventricular dysfunction and left bundle branch block

Masato Nakajima, MDa, Shigeyuki Aomi, MDa, Naoki Matsuda, MDb, Hiroshi Kasanuki, MDb, Masahiro Endo, MDa, Hiromi Kurosawa, MDa Tokyo, Japan

From the Departments of Cardiovascular Surgerya and Cardiology,b Tokyo Women's Medical University, The Heart Institute of Japan, Tokyo, Japan.

Received for publication March 23, 2002. Accepted for publication Aug 28, 2002. Address for reprints: Masato Nakajima, MD, Department of Cardiovascular Surgery, Tokyo Women's Medical University, The Heart Institute of Japan, 8-1 Kawada-cho, Shinjyuku-ward, Tokyo, 162-8666 Japan (E-mail: masato-n@zf6.so-net.ne.jp).

The first 20% of the full text of this article appears below.

Biventricular pacing is currently being explored as a means to improve cardiac function among patients with congestive heart failure. The mechanism of efficacy of this therapy is still unknown, but in patients with left bundle branch block, biventricular pacing resolves ventricular dyssynchrony and ameliorates myocardial wall function. We present a successful aortic valve replacement and biventricular pacemaker implantation for a case of aortic regurgitation with severe left ventricular dysfunction and left bundle branch block.

Clinical summary

A 47-year-old man was referred to our hospital for detailed examination of congestive heart failure. His hemodynamic condition had deteriorated 1 month before, and he required administration of inotropic agents and ventilatory support at another hospital. He gradually recovered from cardiac shock and was transferred to our hospital. On admission, his hemodynamic condition was still unstable, and the chest x-ray film showed cardiomegaly with a cardiothoracic ratio of 66% and massive congestion. Electrocardiography showed complete left bundle branch block with a QRS duration of 202 ms (Figure 1), whereas echocardiography revealed severe aortic regurgitation and left ventricular dilatation and dysfunction (diastolic dimension of 85 mm, systolic . . . [Full Text of this Article]






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