Sterz H, Prager H, Koller H, Haiderer O
Z Kardiol. 1977 Dec;66(12):726-8.
2 methods for the implantation of permanent pacemakers with percutaneous puncture of the subclavian vein are described. The first one was used in 44 patients with the aid of an introducing catheter-set Desilets-Hoffman consisting of guide-wire, inner Teflon dummy catheter and outer thin-walled sheath; through this a shoulder-less electrode catheter no. 8 could be inserted for permanent pacing. The other technique was applied to 20 patients and used thinner special electrodes no. 6F, which could be introduced directly through a plastic cannula inserted with a puncture-needle. The advantages are: diminished risk of infections, local anesthesia instead of general anesthesia, applicability by the cardiologist in the catheterization-laboratory or under a simple fluoroscopy-unit, short stay of patients in the hospital without transfers to other departments, few personnel (1 scrubbed doctor, 1 non-scrubbed nurse), recognition of venous anomalies (singular left superior caval vein) without useless incisions for the patient. Complications such as pneumothorax, puncture of the subclavian artery, and dislocations of the electrodes have also been encountered.
描述了两种经皮穿刺锁骨下静脉植入永久性起搏器的方法。第一种方法借助一套由导丝、内聚四氟乙烯假导管和外薄壁鞘组成的Desilets-Hoffman导入导管装置应用于44例患者;通过这套装置可插入8号无肩电极导管进行永久性起搏。另一种技术应用于20例患者,使用更细的6F特殊电极,该电极可通过与穿刺针一起插入的塑料套管直接导入。优点包括:感染风险降低、采用局部麻醉而非全身麻醉、心脏病专家可在导管室或简单的透视设备下操作、患者住院时间短且无需转至其他科室、人员少(1名刷手医生、1名非刷手护士)、无需对患者进行无用切口即可识别静脉异常(如单一左上腔静脉)。也遇到过气胸、锁骨下动脉穿刺和电极脱位等并发症。