Shimada Yasuyuki, Kawata Masatoshi, Iwasaki Yasushi, Kawachi Hideyuki, Yaku Hitoshi, Kitamura Nobuo
Department of Cardiovascular-Thoracic Surgery, Saiseikai Suita Hospital, Osaka, Japan.
Jpn J Thorac Cardiovasc Surg. 2004 Feb;52(2):75-7. doi: 10.1007/s11748-004-0088-x.
We removed from 4 patients pacemaker leads that had migrated or become infected. Case 1: A 62-year-old man developed uncontrollable infection of the pacing leads. Case 2: A 78-year-old man, whose infected pacemaker was removed, had a second one implanted in the contralateral side; the pacing lead infection from the first procedure, however, was uncontrollable. Case 3: A 56-year-old woman presented with dyspnea and hepatomegaly subsequent to the second implantation of a pacemaker; the pacing leads from the first procedure caused severe stenosis in both the superior and inferior vena cavae. Case 4: A 60-year-old woman had a ruptured and migrated pacing lead in the right ventricle. We operated using a cardiopulmonary bypass and a specially designed plastic tube for removal of the leads. Although Case 2 required reconstruction of the vena cavae, all patients recovered. When removal of pacing leads is necessary, it should be done as soon as possible with cardiopulmonary bypass.
我们从4例患者身上移除了发生移位或感染的起搏器导线。病例1：一名62岁男性出现了起搏器导线无法控制的感染。病例2：一名78岁男性，其感染的起搏器被移除，在对侧植入了第二个起搏器；然而，第一次手术引起的起搏器导线感染无法控制。病例3：一名56岁女性在第二次植入起搏器后出现呼吸困难和肝肿大；第一次手术的起搏器导线导致上腔静脉和下腔静脉严重狭窄。病例4：一名60岁女性右心室的起搏导线发生破裂和移位。我们使用体外循环和一根专门设计的塑料管进行手术以移除导线。尽管病例2需要重建腔静脉，但所有患者均康复。当有必要移除起搏器导线时，应尽快通过体外循环进行。
