床边插入临时起搏器导线时心内双结形成的罕见并发症：一例报告
A rare complication of intracardiac double knotting of temporary pacemaker lead during bedside insertion: a case report.
作者信息
Dattagupta Aditi, Agrawal Shweta, Adhyapak Srilakshmi, Kramadhari Harshith, Konda Abhilash
机构信息
Department of Cardiology, St. John's National academy of Health Sciences, University-Rajiv Gandhi University of Health Sciences, Bengaluru 560034, Karnataka, India.
Division of interventional Radiology, Kasturba Medical College, Manipal University-Manipal academy of Higher Education, Manipal 576104, Karnataka, India.
出版信息
Eur Heart J Case Rep. 2024 Nov 28;8(12):ytae623. doi: 10.1093/ehjcr/ytae623. eCollection 2024 Dec.
BACKGROUND
Temporary pacemaker lead implantation is a common low-risk procedure, but can occasionally get complicated by infections, arrhythmias, thromboembolic events, and perforation of the vessel or the heart. However, intracardiac knotting of the temporary pacemaker lead has been rarely reported. This could lead to vascular or valvular injury, pneumothorax, symptomatic loss of pacing or haemodynamic compromise, and difficult lead removal.
CASE SUMMARY
We are reporting a case of twice twice-knotted temporary pacemaker lead, which to our knowledge has not been reported before. The two knots in the transjugularly inserted temporary pacemaker lead, via a 6F venous sheath made it difficult to retrieve it.
DISCUSSION
We decided to snare the knotted TPI into the inferior vena cava, and then retrieve it via a large-size femoral sheath, thus avoiding the need for a venotomy or any surgical intervention.
背景
临时起搏器导线植入是一种常见的低风险操作，但偶尔会出现感染、心律失常、血栓栓塞事件以及血管或心脏穿孔等并发症。然而，临时起搏器导线的心内打结情况鲜有报道。这可能导致血管或瓣膜损伤、气胸、起搏功能丧失或血流动力学受损，以及导线拔除困难。
病例摘要
我们报告一例临时起搏器导线两次打结的病例，据我们所知此前尚无此类报道。经颈静脉插入的临时起搏器导线通过6F静脉鞘出现的两个结使其难以取出。
讨论
我们决定将打结的临时起搏器导线圈套在下腔静脉内，然后通过大尺寸股静脉鞘将其取出，从而避免了静脉切开术或任何手术干预的需要。
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