Doctors give premature baby a tiny pacemaker in a groundbreaking surgery

Doctors in Kentucky are celebrating after successfully completing a first-of-its kind surgery to save the life of a premature baby. A news release from the Norton Children’s Heart Institute, which is affiliated with the University of Louisville School of Medicine, detailed how physicians used an innovative surgery to transplant a tiny pacemaker into the infant.

According to the release, the baby was born with congenital structural heart defects and complete atrioventricular block (CCAVB), which results in a slow heart rate. It’s a condition that affects roughly one in every 22,000 infants. Traditionally, doctors would have waited until the baby was at least 4.5 to 5.5 pounds to put in the pacemaker, but they determined that any delay may have had fatal results.

“In this instance, the patient was not of the optimal size and medical/conservative management was unsuccessful, so a specially modified pediatric-sized pacemaker also known as an implantable pulse generator (IPG) created by Medtronic was used,” said Soham Dasgupta, M.D., pediatric electrophysiologist, Norton Children’s Heart Institute and UofL assistant professor of pediatric cardiology.

Because of the infant’s small size, the insertion of the pacemaker was anything but routine. The open-heart surgery took just over two hours, and the device measured just 1.16 by 0.65 by 0.38 inches, while weighing 0.18 ounces.

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“While the operative steps might be comparable to the usual pacemaker implantation surgery, this surgery was especially delicate due to the very small size of the baby,” said Bahaaldin Alsoufi, M.D., chief of pediatric cardiothoracic surgery, co-director of Norton Children’s Heart Institute and UofL professor of cardiothoracic surgery.

Dr. Alsoufi noted that in the future, the baby will be connected to a larger pacemaker. “This tiny pacemaker generator was positioned in the abdominal wall on the right side and was connected to the usual leads that were attached to the heart. This novel device will provide the necessary support that the baby currently needs. At the time of repair of the patient’s congenital heart defect in the future, we will be able to utilize these same leads and likely connect them then to a traditional larger pacemaker generator.”

The baby is currently doing well and continuing to recover in the hospital.

“It is remarkable how our team of pediatric specialists came together with the device company to offer a resolution for such a small patient weighing less than three pounds at the time of implant,” Dr. Dasgupta added. “This unique case is unlike any other and we are so pleased to see this patient thriving as a result of the innovative approach.”

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