Bastecký J, Hlava A, Brzek V, Rozsíval V, Chrobák L, Kvasnicka J
I. interni klinika FN, Hradec Králové.
Vnitr Lek. 1990 Oct;36(10):1005-10.
A patient with a ten-year permanent implantation of a pacemaker was admitted on account of a clinically serious syndrome of the vena cava superior. The cause of the syndrome was an angiographically confirmed extensive thrombosis and after its dissolution a fibrous septum in the area of the orifice of the vena cava superior into the right atrium. The septum caused by a fibrous strip at the orifice of the vena cava superior into the right atrium was removed by surgical operation during thoracotomy by dilatation of the original opening in the fibrous septum by a Broca dilator and digitally. The authors recommend, based on their own experience and data in the literature, to use fibrinolytic therapy in clinically severe thrombosis in the area of the vena cava superior or the right atrium caused by an electrode--during temporary or permanent pacing--or by a catheter used for parenteral nutrition.
一名植入起搏器达十年之久的患者因临床上严重的上腔静脉综合征入院。该综合征的病因是血管造影证实的广泛血栓形成，血栓溶解后，上腔静脉进入右心房开口处出现纤维隔膜。通过开胸手术，使用布罗卡扩张器并以手指扩张纤维隔膜原有的开口，切除了由上腔静脉进入右心房开口处的纤维条带所导致的隔膜。作者根据自身经验及文献资料建议，对于因电极（临时或永久起搏时）或用于胃肠外营养的导管导致的上腔静脉或右心房区域临床上严重的血栓形成，应采用纤维蛋白溶解疗法。
