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8g-2. Pacemaker. (Condition description.)

A. Transvenous dual chamber (DDDR) pacemaker in a patient with tetralogy of Fallot/absent left pulmonary artery status post RV-PA conduit (x2) and ventricular septal defect closure. There is marked cardiomegaly secondary to RV dilation following long-standing pulmonary regurgitation. Note the calcification within the conduit and the presence of an atrial septal occluding device (mandatory to abolish the risk of right to left shunting and paradoxical embolus with an intracardiac wire). Note also the presence of pericardial calcification, the etiology of which was unclear in this patient.