Sano Makoto, Urushida Tsuyoshi, Sakakibara Tomoaki, Naruse Yoshihisa, Maekawa Yuichiro
Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ward, Hamamatsu 431-3192, Japan.
J Cardiol Cases. 2020 Nov 19;23(5):218-220. doi: 10.1016/j.jccase.2020.11.001. eCollection 2021 May.
Both a multicenter cohort and a post-approval registry of the Micra™ transcatheter pacemaker (Medtronic, Minneapolis, MN, USA) reported high successful implantation rates (>99%) with long-term stability of electrical performance and long-term safety. Therefore, there has been little discussion on the causes of cases of failure in terms of anatomical findings. We report a case of failure of implantation of the Micra because of a tortuous inferior vena cava (IVC) secondary to severe scoliosis. A retrospective assessment of 3D reconstructed computed tomography imaging could visualize the configuration of the IVC-right atrium junction. A preprocedural anatomical assessment may help to predict the implantability of the transcatheter leadless pacemaker or to image the manipulation of the delivery catheter. < The Micra™ leadless pacemaker had high successful implantation rates (>99%). There has been little discussion on the causes of cases of failure in terms of anatomical findings. We report a case of failure of implantation of the Micra device because of a tortuous inferior vena cava secondary to severe scoliosis. A preprocedural 3D reconstructed computed tomography may help to predict the procedural difficulty of the Micra implantation or to image a manipulation of the delivery catheter.>.
一项关于Micra™经导管起搏器（美敦力公司，美国明尼阿波利斯，明尼苏达州）的多中心队列研究和上市后注册研究均报告了较高的成功植入率（>99%），且电性能具有长期稳定性和长期安全性。因此，关于植入失败病例的解剖学原因几乎没有讨论。我们报告了一例因严重脊柱侧弯继发下腔静脉（IVC）迂曲导致Micra植入失败的病例。对三维重建计算机断层扫描成像进行回顾性评估可以可视化下腔静脉-右心房交界处的形态。术前解剖学评估可能有助于预测经导管无导线起搏器的可植入性或对输送导管的操作进行成像。<Micra™无导线起搏器具有较高的成功植入率（>99%）。关于植入失败病例的解剖学原因几乎没有讨论。我们报告了一例因严重脊柱侧弯继发下腔静脉迂曲导致Micra装置植入失败的病例。术前三维重建计算机断层扫描可能有助于预测Micra植入的操作难度或对输送导管的操作进行成像。>
