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一位90多岁患者经静脉植入式心律转复除颤器（ICD）导线的拔除

Extraction Of Transvenous ICD Leads In An Over-ninety Years Old Patient.

作者信息

Proietti Riccardo, Lombardi Leonida, Quaglia Carlo, Sagone Antonio

机构信息

Cardiac Electrophysiology Laboratory Luigi Sacco Hospital Milano.

出版信息

Indian Pacing Electrophysiol J. 2011 Sep;11(5):145-8. Epub 2011 Oct 2.

PMID:21994472
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3184450/
Abstract

There is a general consensus that once a part of an implanted cardiac device becomes infected, it is usually impossible to cure the infection without completely removing all prosthetic material from the body. Consequently the Heart Rhythm Society (HRS) included the pocket infection or erosion as a class I indication for pacemaker lead exctraction. However, the procedure still carries a high risk of life-threatening complications due to fibrotic attachments between leads, veins, valves or other endocardial structures, notwithstanding specific tools and techniques that have been developed to assist the lead removal, preventing tissue laceration.

摘要

人们普遍认为，一旦植入式心脏设备的某一部分发生感染，如果不从体内完全清除所有假体材料，通常就无法治愈感染。因此，心律协会（HRS）将囊袋感染或糜烂列为起搏器导线拔除的I类适应症。然而，尽管已经开发出特定的工具和技术来辅助导线拔除，防止组织撕裂，但由于导线、静脉、瓣膜或其他心内膜结构之间的纤维化粘连，该手术仍具有发生危及生命并发症的高风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09a/3184450/ef3f339dde7f/ipej110145-02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09a/3184450/cb354e012b0f/ipej110145-01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09a/3184450/ef3f339dde7f/ipej110145-02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09a/3184450/cb354e012b0f/ipej110145-01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f09a/3184450/ef3f339dde7f/ipej110145-02.jpg

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本文引用的文献

1
Impact of timing of device removal on mortality in patients with cardiovascular implantable electronic device infections.器械移除时机对心血管植入式电子设备感染患者死亡率的影响。
Heart Rhythm. 2011 Nov;8(11):1678-85. doi: 10.1016/j.hrthm.2011.05.015. Epub 2011 May 27.
2
Pacemaker and defibrillator lead extraction.起搏器和除颤器导线拔除术。
Circulation. 2011 Mar 22;123(11):e378-80. doi: 10.1161/CIRCULATIONAHA.110.987354.
3
Extraction of cardiac rhythm devices: indications, techniques and outcomes for the removal of pacemaker and defibrillator leads.
心脏节律装置取出术：起搏器和除颤器导线取出的适应证、技术和结果。
Int J Clin Pract. 2010 Jul;64(8):1140-7. doi: 10.1111/j.1742-1241.2010.02338.x.
4
Initial experience with the Evolution mechanical dilator sheath for lead extraction: safety and efficacy.Evolution 机械扩张鞘在经皮心脏介入治疗中的应用经验：安全性和有效性。
Heart Rhythm. 2010 Jul;7(7):870-3. doi: 10.1016/j.hrthm.2010.03.019. Epub 2010 Mar 23.
5
Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management: this document was endorsed by the American Heart Association (AHA).经静脉导线拔除：心律学会关于设施、培训、适应症及患者管理的专家共识：本文件获美国心脏协会（AHA）认可。
Heart Rhythm. 2009 Jul;6(7):1085-104. doi: 10.1016/j.hrthm.2009.05.020. Epub 2009 May 22.
6
Predictors of complications of endovascular chronic lead extractions from pacemakers and defibrillators: a single-operator experience.起搏器和除颤器血管内慢性导线拔除并发症的预测因素：单操作者经验
J Cardiovasc Electrophysiol. 2009 Feb;20(2):171-5. doi: 10.1111/j.1540-8167.2008.01283.x. Epub 2008 Sep 3.
7
Extraction of transvenous pacing and ICD leads.经静脉起搏和植入式心律转复除颤器导线的拔除
Pacing Clin Electrophysiol. 2008 Jun;31(6):736-52. doi: 10.1111/j.1540-8159.2008.01079.x.