Gillette P C, Edgerton J, Kratz J, Zeigler V
South Carolina Children's Heart Center, Medical University of South Carolina, Charleston.
Pacing Clin Electrophysiol. 1991 Jul;14(7):1089-92. doi: 10.1111/j.1540-8159.1991.tb02838.x.
Implantation technique for pediatric pacemaking has evolved from predominantly epicardial to predominantly endocardial. One of the potential problems with endocardial pacing in children is their very thin subcutaneous tissue, which can result in an unpleasant cosmetic result. The superficialness of the pacemaker pulse generator also may render it more susceptible to erosion and infection. A series is presented of pediatric patients who underwent implantation of a transvenous bipolar pacing system in the pediatric catheterization laboratory. The pacemaker was implanted under the pectoralis major muscle after a muscle spreading incision was made. The lead was also introduced into the subclavian vein under the pectoralis muscle. No complications resulted, and the cosmetic result was judged to be good to excellent by the parents and physicians. No infections or erosions occurred. The subpectoral pocket is recommended as the preferred site for implantation of transvenous pacemakers in pediatric patients.
小儿起搏器植入技术已从主要采用心外膜途径发展为主要采用心内膜途径。小儿心内膜起搏的潜在问题之一是其皮下组织非常薄，这可能导致不理想的美容效果。起搏器脉冲发生器位置表浅也可能使其更容易发生侵蚀和感染。本文介绍了一组在小儿心导管室接受经静脉双极起搏系统植入的患儿。在做了肌肉撑开切口后，将起搏器植入胸大肌下方。导线也经胸大肌下方引入锁骨下静脉。未发生并发症，家长和医生判定美容效果良好至极佳。未发生感染或侵蚀。对于小儿患者，推荐将胸大肌下囊袋作为植入经静脉起搏器的首选部位。
