Le Tourneau T, Klug D, Lacroix D, Kacet S, Lekieffre J
Service de Cardiologie A, Hôpital Cardiologique de Lille, France.
J Cardiovasc Electrophysiol. 1996 Jun;7(6):539-41. doi: 10.1111/j.1540-8167.1996.tb00561.x.
We report a case of pericardial constriction associated with defibrillator patches developing 4.5 years after implantation. This constriction was related to the presence of a large pericardial mass that had developed above the defibrillator patch. This mass, which had a calcified superior border, suggested former hematoma associated with pericardial fibrosis. It induced significant compression of the right ventricle and a dumb-bell deformity of the left ventricle. The hemodynamic picture was of elastic-form constrictive pericarditis. Because of previous cerebral stroke during cardiac surgery, the patient was discharged on pharmacologic treatment after improvement of his functional status. Since removal of epicardial patches is an effective treatment of constriction, constrictive pericarditis should be systematically considered in patients with epicardial patch electrodes and impairment of functional status.
我们报告一例植入除颤器贴片4.5年后发生的心包缩窄病例。这种缩窄与除颤器贴片上方形成的一个大的心包肿块有关。该肿块上缘钙化，提示既往存在与心包纤维化相关的血肿。它导致右心室明显受压，左心室呈哑铃状畸形。血流动力学表现为弹性型缩窄性心包炎。由于心脏手术期间曾发生脑卒，患者在功能状态改善后出院接受药物治疗。由于切除心外膜贴片是治疗缩窄的有效方法，对于有心外膜贴片电极且功能状态受损的患者，应系统考虑缩窄性心包炎的可能。
