Ventricular Pacing Through Coronary Sinus in Patients With Tricuspid Prosthesis

We report four cases of ventricular pacing through the coronary sinus in patients with tricuspid biological valves for whom recordings of atrioventricular block indicated required pacemaker implantation. To avoid risk of tricuspid damage, endocardial pacemaker implantation is not recommended for patients with prior tricuspid valve replacement. These patients historically undergo epicardial lead implantation on the diaphragmatic surface of the ventricle, requiring a lateral thoracotomy, which remains a challenging technique. For our cases, satisfactory pacing data was collected for a 6-year follow-up. This technique enables a minimally invasive approach and effective stimulation for patients with a prosthetic tricuspid valve. (Ann Thorac Surg 2010; 89: e51-2) (C) 2010 by The Society of Thoracic Surgeons