PERCUTANEOUS TRANSHEPATIC DUAL-CHAMBER PACING IN CHILDREN WITH FONTANCIRCULATION

Permanent pacing is often required following the Fontan operation and is usually performed epicardially as there is no direct access to the ventricle from the systemic veins. Dual chamber endocardial pacing was achieved by the transhepatic approach in two children with Fontan cir culation. The patients were a 7 year old boy with left atrial isomeris m, single ventricle with pulmonary stenosis, interrupted inferior vena caval vein with azygous continuation, and direct drainage of the hepa tic veins to the right sided atrium, and a 6 year old girl with tricus pid atresia. This approach to endocardial pacemaker implantation is po tentially of considerable value in patients who do not have direct acc ess to the ventricle from the systemic veins.