Leacche Marzia, Katsnelson Yan, Arshad Hassan, Mihaljevic Tomislav, Rawn James D, Sweeney Michael O, Byrne John G
Pacing Clin Electrophysiol. 2004 Feb;27(2):262-3. doi: 10.1111/j.1540-8159.2004.00424.x.
Pacemaker lead extraction has been shown to be an effective and safe treatment for infected permanent pacemaker leads, however, they may lead to potentially serious complications, usually occurring during the extraction procedure. This report describes a case of a 48-year-old woman with a patent persistent left SVC and an infected permanent pacemaker lead of a DDD pacing system who underwent transvenous laser-assisted lead extraction using a combined SVC and femoral approach. Two days after the procedure the patient developed symptoms of SVC obstruction requiring surgical intervention. The right SVC was found to be almost completely destroyed with only a thin strip of the lateral wall intact and active bleeding. The probable causative mechanisms and surgical management are discussed.
起搏器导线拔除术已被证明是治疗感染的永久性起搏器导线的一种有效且安全的方法，然而，该手术可能会导致潜在的严重并发症，通常发生在拔除过程中。本报告描述了一例48岁女性患者，其存在永存左上腔静脉且DDD起搏系统的永久性起搏器导线发生感染，该患者采用上腔静脉和股静脉联合入路进行了经静脉激光辅助导线拔除术。术后两天，患者出现上腔静脉梗阻症状，需要手术干预。术中发现右心房几乎完全毁损，仅外侧壁有一薄层完整且有活动性出血。文中讨论了可能的致病机制及手术处理方法。
