Pingitore Annachiara, Calcagno Simone, Salvador Loris, Mennuni Silvia, Cavarretta Elena
Department of Cardiology, San Paolo Hospital, Civitavecchia, Italy.
Department of Cardiac Surgery, San Bortolo-AULSS 8 Berica, Vicenza, Italy.
Eur Heart J Case Rep. 2022 Apr 15;6(6):ytac154. doi: 10.1093/ehjcr/ytac154. eCollection 2022 Jun.
Currently, the leadless pacemaker indications are limited to few and highly selected cases.
We describe the first reported case of an atrioventricular Micra™ leadless pacemaker implantation complicated by tricuspid posterior leaflet flail with severe regurgitation in a 29-year-old man affected by asymptomatic and progressive high degree atrio-ventricular block. The patient was then treated with endoscopic tricuspid valve repair, leadless pacemaker removal and implantation of an epicardial pacemaker.
Leadless pacemaker complications are multiple, hence it is essential to ensure a safe procedure, especially in the younger patients. We thought that the application of a transesophageal echocardiography guidance might mitigate the risk of major complications.
目前，无导线起搏器的适应症仅限于少数经过严格筛选的病例。
我们报告了首例房室Micra™无导线起搏器植入术，该病例发生在一名29岁男性身上，他患有无症状且进行性高度房室传导阻滞，植入过程中出现三尖瓣后叶连枷样病变并伴有严重反流。该患者随后接受了内镜下三尖瓣修复、取出无导线起搏器并植入了心外膜起搏器。
无导线起搏器并发症多种多样，因此确保手术安全至关重要，尤其是对于年轻患者。我们认为应用经食管超声心动图引导可能会降低主要并发症的风险。
