Trigano J A, Poncet M, Lauribe P, Paganelli F, Raybaud C, Gérard R, Lévy S
Service de cardiologie, CHU Nord, Marseille.
Arch Mal Coeur Vaiss. 1994 Mar;87(3):403-6.
During reoperation for pacemaker implantation, venous catheterisation of the homolateral subclavian vein encountered obstruction at the brachiocephalic vein. Balloon angioplasty of the severe brachiocephalic stenosis was performed via the femoral vein. After repeat subclavian venous catheterisation two new pacing wires could be introduced without difficulty followed by active fixation in the atrium and passive fixation in the ventricular apex. The initial ventricular pacing wire was isolated and respected. The femoral vein approach gave simple and direct access to the site of dilatation at a distance to the operative field which was shielded from an infectious risk. The technique and results of percutaneous venous recanalisation have not been extensively analysed during reoperation for cardiac pacing. In chronic cardiac pacing, the success of homolateral operation despite venous occlusion or stenosis, ensures preservation of the venous capital.
在进行起搏器植入的再次手术时，同侧锁骨下静脉的静脉插管在头臂静脉处遇到阻塞。通过股静脉对严重的头臂静脉狭窄进行了球囊血管成形术。再次进行锁骨下静脉插管后，两根新的起搏导线可以顺利插入，随后主动固定于心房，被动固定于心室尖部。最初的心室起搏导线被分离并保留。股静脉途径提供了简单直接的通路，可到达远离手术区域的扩张部位，从而避免了感染风险。在心脏起搏再次手术过程中，经皮静脉再通技术及其结果尚未得到广泛分析。在慢性心脏起搏中，尽管存在静脉闭塞或狭窄，同侧手术的成功确保了静脉资源的保留。
