Imnadze Guram, Awad Khaled, Kranig Wolfgang, Giorgberidze Irakli
Tex Heart Inst J. 2020 Feb 1;47(1):23-26. doi: 10.14503/THIJ-18-6713. eCollection 2020 Feb.
The number of procedures for upgrading implantable devices for cardiac resynchronization therapy has increased considerably during the last decade. A major challenge that operators face in these circumstances is occlusion of the access vein. We have modified a pull-through method to overcome this obstacle. Six consecutive patients with occluded access veins and well-developed collateral networks underwent a procedure in which the occluded vein was recanalized by snaring the existing atrial lead via transfemoral access. Upgrading the device was successful in all patients; none had intraprocedural complications. Our experience shows that our modified pull-through technique may be a feasible alternative for upgrading cardiac resynchronization therapy in patients with venous occlusion.
在过去十年中，用于心脏再同步治疗的植入式设备升级手术的数量大幅增加。在这种情况下，操作人员面临的一个主要挑战是进入静脉的阻塞。我们改进了一种牵拉技术以克服这一障碍。连续六名进入静脉阻塞且侧支网络发达的患者接受了一项手术，通过经股静脉通路套住现有的心房导线，使阻塞的静脉再通。所有患者的设备升级均成功；术中无并发症发生。我们的经验表明，我们改进的牵拉技术可能是静脉阻塞患者心脏再同步治疗升级的一种可行替代方法。
