Jackson Kevin P
Department of Medicine, Division of Cardiology, Duke University Medical Center, Box 3816, Durham, NC 27710, USA.
Card Electrophysiol Clin. 2018 Dec;10(4):675-680. doi: 10.1016/j.ccep.2018.07.005.
With expanding indications for cardiac resynchronization therapy and increased survival of patients with cardiovascular disease, the need for lead addition or revision in the presence of an existing implantable electronic device is likely to increase. Partial or complete venous occlusion is frequently encountered and can be a significant barrier to successful procedural outcomes. Percutaneous options, including subclavian venoplasty, can reduce the need for significantly more invasive and morbid procedures and can readily be learned by the implanting physician. Additional invasive techniques, such as coronary sinus venoplasty and stenting, can be useful in cases of difficult left ventricular lead placement.
随着心脏再同步治疗适应证的扩大以及心血管疾病患者生存率的提高,在已有植入式电子设备的情况下增加或更换导线的需求可能会增加。部分或完全静脉闭塞经常出现,并且可能是手术成功的重大障碍。经皮治疗方案,包括锁骨下静脉成形术,可以减少对创伤性大得多且更具病态的手术的需求,并且植入医生可以很容易地学会。其他侵入性技术,如冠状静脉窦成形术和支架置入术,在左心室导线放置困难的情况下可能有用。