Orton E Christopher
Department of Clinical Sciences, Colorado State University, Fort Collins, CO, 80525, USA.
J Vet Cardiol. 2019 Apr;22:65-71. doi: 10.1016/j.jvc.2018.11.004. Epub 2018 Dec 11.
Epicardial pacemaker implantation can be performed as a lone procedure or in combination with another thoracic or abdominal surgery. This article reviews the current literature and describes a minimally invasive approach for epicardial pacemaker implantation in small animals. The principal advantage of epicardial pacing is that it avoids contact with blood and intracardiac structures and thereby avoids uncommon but potentially devastating complications associated with endocardial pacemaker implantation. Epicardial pacing as a lone procedure can be accomplished via an abdominal transdiaphragmatic or minimal incision thoracotomy approach (minithoracotomy). A minithoracotomy offers the advantages of being less invasive and providing more direct access to the cardiac surface for suturing of epicardial electrodes. Epicardial pacing is a viable option for smaller animals, animals with pre-existing infections, animals at risk for thrombotic complications, or animals undergoing another thoracic or abdominal surgery.
心外膜起搏器植入术可单独进行，也可与其他胸腹部手术联合进行。本文回顾了当前文献，并描述了一种用于小动物心外膜起搏器植入的微创方法。心外膜起搏的主要优点是避免与血液和心内结构接触，从而避免与心内膜起搏器植入相关的罕见但可能具有毁灭性的并发症。心外膜起搏作为单独的手术可通过经腹横膈膜或小切口开胸术（微创开胸术）完成。微创开胸术具有侵入性较小且能更直接地接近心脏表面以缝合心外膜电极的优点。心外膜起搏对于较小的动物、已有感染的动物、有血栓形成并发症风险的动物或正在接受其他胸腹部手术的动物来说是一种可行的选择。
