Oba Junichi, Aoki Hidetoshi, Takigami Ko, Eya Kazuhiro, Kubota Suguru, Shingu Yasushige
Department of Cardiothoracic Surgery, Asahikawa City Hospital, Hokkaido.
J Cardiol. 2005 Feb;45(2):69-73.
An 83-year-old woman was transferred to our hospital because of pacing failure and suspected ventricular perforation by a permanent pacing lead. She had undergone permanent pacemaker implantation 5 months previously. Chest radiography showed the pacing lead running out of the cardiac shadow. Computed tomography and echocardiography confirmed the diagnosis of ventricular perforation by the pacing lead. No evidence of cardiac tamponade was found. The lead was surgically removed through a median sternotomy. Intraoperatively, the lead was found perforating the ventricle and the pericardium, and reaching into the left pleural cavity but not injuring the left lung. A pacing lead may potentially injure the heart or the lung. Regular check-up of lead position and pacing status is recommended.
一名83岁女性因起搏功能衰竭及怀疑永久性起搏导线导致心室穿孔而转入我院。她5个月前接受了永久性起搏器植入术。胸部X线片显示起搏导线穿出心影。计算机断层扫描和超声心动图证实了起搏导线导致心室穿孔的诊断。未发现心脏压塞的证据。通过正中胸骨切开术手术取出导线。术中发现导线穿破心室和心包,进入左胸腔,但未损伤左肺。起搏导线可能会潜在地损伤心脏或肺。建议定期检查导线位置和起搏状态。