123 Kolkata: A 33-year-old woman, who had previously received a Glen Shunt procedure in childhood due to a congenital heart condition, got a leadless pacemaker at a Kolkata hospital. According to the hospital, this marks the first global instance of implementing a leadless pacemaker in a Glenn Shunt case. The medical team noted that conventional pacemaker installation was not feasible due to the previous vein alterations from the Glen Shunt procedure. The medical team at Medica Superspecialty Hospital, affiliated with the Manipal group, intends to publish this case study in an American medical journal.
Rinku Majhi was diagnosed at birth with tetralogy of Fallot, a condition where pulmonary valve obstruction between the right ventricle and lung artery restricts normal blood flow to the lungs, resulting in cyanosis.
During her childhood, she underwent an intracardiac repair and bilateral Glenn Shunt, a palliative surgical intervention for children with cyanotic congenital heart disease. The procedure connected the superior vena cava (SVC), which transports deoxygenated blood from the upper body to the pulmonary artery to improve pulmonary blood circulation. A subsequent epicardial pacing was performed, where the lead provided electrical stimulation to the heart. This pacing system required replacement due to failure.
The structural modifications from the Glen Shunt made traditional pacemaker implementation impossible, as it requires venous access. The veins had been severed and redirected to the pulmonary arteries. Instead, the wireless pacemaker was inserted through the groin, placing a small capsule directly into the right ventricle.
"To our knowledge, there is no documented case of a leadless pacemaker implantation in a patient with Tetralogy of Fallot repair and Glenn Shunt. We are in the process of submitting the paper in a US journal," said interventional cardiologist & dlectrophysiologist Dilip Kumar, director of the cath lab who led procedure, joined by Anil Kumar Singhi, paediatric cardiology head, Somnath Dey, cardiac anaesthesiologist and Prakash Kumar Hazra, director and head, Cardiology, Manipal Hospital, Dhakuria.