Shimada Yasuyuki, Yaku Hitoshi, Kawata Masatoshi, Oka Katsuhiko, Shuntoh Keisuke, Okano Takahisa, Takahashi Akiyuki, Fukumoto Atsushi, Hayashida Kyoko, Kitamura Nobuo
Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kawaramachi, Japan.
Pacing Clin Electrophysiol. 2002 Feb;25(2):223-5. doi: 10.1046/j.1460-9592.2002.00223.x.
A 56-year-old woman presented with general fatigue, dyspnea on exercise, and hepatomegaly subsequent to secondary implantation of a pacemaker. On admission, cardiac echo examination showed tricuspid valve regurgitation due to a migrated looped lead. At surgery, there was evidence of severe stenosis at both orifices of the superior and inferior vena cavae due to fibrous tissue around the leads. We removed the fibrous tissue, pacing leads, and generator. New leads were anchored onto the epicardium and a generator was inserted under the rectus muscle. The postoperative course was satisfactory and the symptoms disappeared.
一名56岁女性因起搏器二次植入后出现全身乏力、运动性呼吸困难及肝肿大前来就诊。入院时，心脏超声检查显示因导线移位呈袢状导致三尖瓣反流。手术中发现，由于导线周围的纤维组织，上、下腔静脉开口处均存在严重狭窄。我们切除了纤维组织、起搏导线和发生器。将新的导线固定于心外膜，并在腹直肌下植入了发生器。术后恢复过程顺利，症状消失。
