Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité (DHZC), Augustenburger Platz 1, Berlin 13353, Germany.
Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, Berlin 13353, Germany.
Europace. 2024 Jun 3;26(6). doi: 10.1093/europace/euae151.
Debulking of infective mass to reduce the burden if infective material is a fundamental principle in the surgical management of infection. The aim of this study was to investigate the validity of this principle in patients undergoing transvenous lead extraction in the context of bloodstream infection (BSI).
We performed an observational single-centre study on patients that underwent transvenous lead extraction due to a BSI, with or without lead-associated vegetations, in combination with a percutaneous aspiration system during the study period 2015-22. One hundred thirty-seven patients were included in the final analysis. In patients with an active BSI at the time of intervention, the use of a percutaneous aspiration system had a significant impact on survival (log-rank: P = 0.0082), while for patients with a suppressed BSI at the time of intervention, the use of a percutaneous aspiration system had no significant impact on survival (log-rank: P = 0.25).
A reduction of the infective burden by percutaneous debulking of lead vegetations might improve survival in patients with an active BSI.
减轻感染性物质的负担以降低感染性材料的风险是感染外科治疗的基本原则。本研究的目的是在发生血流感染（BSI）的患者中经静脉导线拔除术的情况下研究这一原则的有效性。
我们对 2015-22 年期间接受经静脉导线拔除术的因 BSI 合并经皮抽吸系统而导致的伴有或不伴有导线相关赘生物的患者进行了一项观察性单中心研究。最终分析纳入了 137 例患者。在干预时存在活动性 BSI 的患者中，使用经皮抽吸系统对生存有显著影响（对数秩检验：P = 0.0082），而在干预时存在抑制性 BSI 的患者中，使用经皮抽吸系统对生存没有显著影响（对数秩检验：P = 0.25）。
通过经皮去除导线赘生物来减轻感染负担可能会改善活动性 BSI 患者的生存。
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