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经房间隔穿刺消融左侧旁路后出现Gerbode型缺损。

Gerbode type defect after trans-septal puncture for ablation of left-sided accessory pathway.

作者信息

Eslami Masoud, Mollazadeh Reza, Sattarzadeh-Badkoubeh Roya

机构信息

Assistant Professor, Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Associate Professor, Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

ARYA Atheroscler. 2018 May;14(3):139-141. doi: 10.22122/arya.v14i3.1671.

DOI:10.22122/arya.v14i3.1671
PMID:30349577
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6191576/
Abstract

BACKGROUND

Trans-septal puncture (TSP) is a safe and effective method to approach left atrium and ventricle. Nowadays, cardiac electrophysiologists perform this procedure routinely to treat left-sided arrhythmias.

CASE REPORT

A 45-year-old man was referred to our center due to Wolff-Parkinson-White (WPW) syndrome. After trans-septal puncture, contrast injection into the sheath showed that it was in the left ventricle (LV) rather than left atrium. Trans-esophageal echocardiography confirmed left ventricle outflow tract to right atrial (RA) jet. Follow-up echocardiography showed that the tract was present up to 18 months, but considering that the patient was asymptomatic, endovascular or surgical closure was not done.

CONCLUSION

Our case with an 18-month follow-up period, highlights the conservative approach in asymptomatic patients with this complication.

摘要

背景

经房间隔穿刺术（TSP）是进入左心房和左心室的一种安全有效的方法。如今，心脏电生理学家常规进行此操作以治疗左侧心律失常。

病例报告

一名45岁男性因预激综合征（WPW）转诊至我们中心。经房间隔穿刺后，向鞘管内注入造影剂显示其位于左心室（LV）而非左心房。经食管超声心动图证实存在左心室流出道至右心房（RA）的分流。随访超声心动图显示该分流持续了18个月，但鉴于患者无症状，未进行血管内或手术封堵。

结论

我们这个随访期为18个月的病例，凸显了对有此并发症的无症状患者采取保守治疗方法的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e065/6191576/596fc47326bd/ARYA-14-139f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e065/6191576/18179528df59/ARYA-14-139f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e065/6191576/596fc47326bd/ARYA-14-139f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e065/6191576/18179528df59/ARYA-14-139f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e065/6191576/596fc47326bd/ARYA-14-139f2.jpg

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本文引用的文献

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不同心脏手术经房间隔穿刺导管的并发症。
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Heart Rhythm. 2012 Dec;9(12):2089-90. doi: 10.1016/j.hrthm.2011.08.008. Epub 2011 Aug 9.
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