Menezes Júnior Antônio da Silva, Magalhães Thaís Rodrigues, Morais Alana de Oliveira Alarcão
Escola de Ciências Médicas, Farmacêuticas e Biomédicas of the Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil.
Braz J Cardiovasc Surg. 2018 Mar-Apr;33(2):194-202. doi: 10.21470/1678-9741-2017-0144.
In the last two decades, the increased number of implants of cardiac implantable electronic devices has been accompanied by an increase in complications, especially infection. Current recommendations for the appropriate treatment of cardiac implantable electronic devices-related infections consist of prolonged antibiotic therapy associated with complete device extraction. The purpose of this study was to analyze the importance of percutaneous extraction in the treatment of these devices infections.
A systematic review search was performed in the PubMed, BVS, Cochrane CENTRAL, CAPES, SciELO and ScienceDirect databases. A total of 1,717 studies were identified and subsequently selected according to the eligibility criteria defined by relevance tests by two authors working independently.
Sixteen studies, describing a total of 3,354 patients, were selected. Percutaneous extraction was performed in 3,081 patients. The average success rate for the complete percutaneous removal of infected devices was 92.4%. Regarding the procedure, the incidence of major complications was 2.9%, and the incidence of minor complications was 8.4%. The average in-hospital mortality of the patients was 5.4%, and the mortality related to the procedure ranged from 0.4 to 3.6%. The mean mortality was 20% after 6 months and 14% after a one-year follow-up.
Percutaneous extraction is the main technique for the removal of infected cardiac implantable electronic devices, and it presents low rates of complications and mortality related to the procedure.
在过去二十年中，心脏植入式电子设备植入数量的增加伴随着并发症的增多，尤其是感染。目前针对心脏植入式电子设备相关感染的适当治疗建议包括延长抗生素治疗并完全取出设备。本研究的目的是分析经皮取出术在治疗这些设备感染中的重要性。
在PubMed、BVS、Cochrane CENTRAL、CAPES、SciELO和ScienceDirect数据库中进行了系统综述检索。共识别出1717项研究，随后根据两位独立工作的作者通过相关性测试定义的纳入标准进行筛选。
选择了16项研究，共描述了3354例患者。3081例患者接受了经皮取出术。经皮完全取出感染设备的平均成功率为92.4%。关于该手术，主要并发症的发生率为2.9%，次要并发症的发生率为8.4%。患者的平均住院死亡率为5.4%，与手术相关的死亡率在0.4%至3.6%之间。6个月后的平均死亡率为20%，一年随访后的死亡率为14%。
经皮取出术是取出感染的心脏植入式电子设备的主要技术，且该手术相关的并发症和死亡率较低。
