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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.

DOI:10.1111/pace.14594
PMID:36205644
Abstract

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.

摘要

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。

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Pacing Clin Electrophysiol. 2023 Mar;46(3):261-263. doi: 10.1111/pace.14594. Epub 2022 Oct 27.
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Very-late-phase perforation of the septum and left ventricle by a passive fixation pacemaker lead: Case report.被动固定起搏器导线导致的室间隔和左心室极晚期穿孔:病例报告
HeartRhythm Case Rep. 2023 Aug 6;9(10):741-744. doi: 10.1016/j.hrcr.2023.07.019. eCollection 2023 Oct.
2
Surgical management of left bundle branch pacing lead causing septal and left ventricular perforation.左束支起搏导线致间隔及左心室穿孔的外科处理
HeartRhythm Case Rep. 2023 May 11;9(8):520-523. doi: 10.1016/j.hrcr.2023.05.001. eCollection 2023 Aug.