Sugimoto Ai, Watanabe Hiroshi, Takahashi Masashi, Shiraishi Shuichi, Watanabe Maya, Hayashi Junichi
Kyobu Geka. 2010 Feb;63(2):116-8.
A 6-day-old girl underwent pacemaker implantation for complete atrioventricular block through a subxiphoid incision. Epicardial leads were sutured on the right ventricle, and the pulse generator was buried in a subcutaneous pocket on the abdomen. After 3 days, the pacemaker site became infected. The whole pacing system was extracted immediately and replaced by temporary pacing leads. After the infection was controlled, a new pacemaker was implanted through a left thoracotomy during which an original Blalock-Taussig shunt was established. The new pulse generator was buried in a subcutaneous pocket in the left precordial area. The patient's postoperative course was uneventful, and there have been no signs of lead problems or re-infection. Using temporary pacing leads as a bridge to implant a new system and choosing a precordial subcutaneous pocket for the implantation site following suturing of the leads on the left ventricle through a left thoracotomy were useful in this case.
一名6天大的女婴通过剑突下切口植入起搏器,用于治疗完全性房室传导阻滞。心外膜导线缝合在右心室,脉冲发生器埋于腹部皮下囊袋。3天后,起搏器部位发生感染。立即取出整个起搏系统,更换为临时起搏导线。感染得到控制后,通过左胸廓切开术植入新的起搏器,术中建立了原有的布莱洛克-陶西格分流术。新的脉冲发生器埋于左胸前区皮下囊袋。患者术后恢复顺利,未出现导线问题或再次感染的迹象。在本例中,使用临时起搏导线作为植入新系统的桥梁,并在通过左胸廓切开术将导线缝合在左心室后选择胸前皮下囊袋作为植入部位是有效的。