ObjectiveTo compare the X-ray projection doses during leadless pacemaker implantation and conventional single chamber ventricular pacemaker (VVI) implantation. MethodsThis study included all patients who underwent leadless pacemaker implantation and VVI pacemaker implantation performed by the same principal investigator team using the same digital subtraction angiography (DSA) machine in the West China Hospital of Sichuan University from August 3rd, 2018 to February 18th, 2020. Among the enrolled patients, 27 who underwent leadless pacemaker implantation were included in the case group, whereas 38 who underwent conventional VVI implantation were included in the control group. Data regarding the intraoperative dose area product (DAP), air kerma (AK), duration of X-ray fluoroscopy, number of exposed sequences on the film, total number of frames on the film, operation time, and BMI were collected to investigate the causes of the differences. ResultsThe case group received a higher X-ray projection dose than the control group, and there were statistically significant differences between the two groups in terms of DAP, AK, duration of X-ray fluoroscopy, the number of exposed sequences on the film, the total number of frames on the film, and operation time (P<0.05). ConclusionPatients who underwent leadless pacemaker implantation are exposed to more radiation than those who underwent conventional VVI implantation.
Reoperation due to degenerated bioprostheses is an important factor of high-risk thoracic surgeries. In 2020 ACC/AHA guideline, Valve in Valve (ViV) was recommended for high-risk patient instead of surgical mitral valve replacement. This report described a 77-year-old male patient with a failed mitral bioprosthetic valve, evaluated at high risk of surgery, received a transvenous, transseptal transcatheter mitral valve replacement (TMVR). Tracheal intubation was removed at CCU 3 h after surgery without discomfort such as polypnea. The patient was transferred out of the CCU and discharged on the 3rd day. Compared with transapical access, transvenous transseptal access was less invasive, with shorter duration in CCU and hospitalization.