一种罕见的并发症：右心室导线经左心室和室间隔穿孔并毗邻左前降支动脉。
A rare complication: Right ventricular lead perforation abutting the left anterior descending artery through the left ventricle and the septum.
作者信息
Mililis Panagiotis, Saplaouras Athanasios, Konstantinidou Eleni, Papakonstantinou Konstantinos, Rorris Fillipos, Mpatsouli Athina, Dragasis Stylianos, Vlachos Konstantinos, Charitos Christos, Xydonas Sotirios
机构信息
Arrhythmia Unit, Laboratory of Cardiac Electrophysiology, Second Cardiology Department, Evangelismos General Hospital of Athens, Athens, Greece.
Department of Cardiothoracic Surgery, Evangelismos General Hospital of Athens, Greece.
出版信息
Pacing Clin Electrophysiol. 2023 Mar;46(3):261-263. doi: 10.1111/pace.14594. Epub 2022 Oct 27.
BACKGROUND
Cardiac perforation is an uncommon complication of transvenous pacemaker implantation typically occurring through the apex.
CASE SUMMARY
We report a case of patient, in whom ventricular lead perforation was confirmed 6 days after implantation of a dual chamber pacemaker. The ventricular lead was perforating the ventricular septum, near the left anterior descending artery, exiting the left ventricle. The patient underwent cardiac surgery due to the lead perforation as also as aortic valve replacement due to concomitant severe aortic valve stenosis.
DISCUSSION
The presented case report is a rare case of lead perforation through the LV and illustrates that lead perforation can still occur even after placement of the RV lead in septal position and even through the thick ventricular wall.
背景
心脏穿孔是经静脉起搏器植入术罕见的并发症，通常发生于通过心尖部植入时。
病例摘要
我们报告一例患者，在双腔起搏器植入6天后证实发生心室导线穿孔。心室导线穿透室间隔，靠近左前降支，穿出左心室。由于导线穿孔以及合并严重主动脉瓣狭窄，患者接受了心脏手术及主动脉瓣置换术。
讨论
本病例报告是导线经左心室穿孔的罕见病例，表明即使右心室导线置于间隔位置且穿过较厚的心室壁后仍可能发生导线穿孔。
Zotero 插件