经静脉通过持续左上腔静脉植入心脏复律除颤器。
Transvenous cardioverter-defibrillator placement via a persistent left superior vena cava.
作者信息
Pavlić Liesl K, Harken Alden H, Sethna Dhun
机构信息
The Department of Medicine, Alameda County Medical Center, Oakland, California 94602, USA.
出版信息
J Card Surg. 2007 Mar-Apr;22(2):152-3. doi: 10.1111/j.1540-8191.2007.00361.x.
BACKGROUND
Persistent left superior vena cava (LSVC) is relatively uncommon. Due to its unanticipated location, large vessel injury is disproportionately common during transvenous intracardiac device implantation.
AIM
The purposes of this report are: (1) to remind surgeons/physicians of this (LSVC) anatomic abnormality and, (2) to reassure surgeons/physicians that successful dysarrhythmia rescue is feasible with intracardiac defibrillator devices despite the obligate atypical anatomic positioning of the defibrillator electrodes.
CASE SUMMARY
Catheter position in an LSVC appears fluoroscopically to traverse the left pleural space. The transvenous lead must negotiate a U-turn to enter the right ventricle.
CONCLUSION
Despite the unconventional configuration of the intracardiac electrodes necessitated by the anatomy of a persistent LSVC, successful defibrillation is possible.
背景
永存左上腔静脉（LSVC）相对少见。由于其位置难以预料，在经静脉心内装置植入过程中，大血管损伤的发生率不成比例地高。
目的
本报告的目的是：（1）提醒外科医生/内科医生注意这种（LSVC）解剖异常，（2）向外科医生/内科医生保证，尽管除颤器电极的解剖位置不典型，但使用心内除颤器装置成功抢救心律失常是可行的。
病例摘要
在荧光镜下，LSVC中的导管位置似乎穿过左胸膜腔。经静脉导线必须绕一个U形弯才能进入右心室。
结论
尽管永存LSVC的解剖结构使心内电极的配置非常规，但成功除颤是可能的。
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