Telfer E A, Olshansky B, Cadman C, Prater S P, Lanzarotti C, Miles R H, Blakeman B P
Department of Medicine, Loyola University of Chicago Medical Center, Maywood, Illinois 60153, USA.
Ann Thorac Surg. 1997 Jul;64(1):175-80. doi: 10.1016/s0003-4975(97)00345-7.
The Telectronics 330-801 atrial J (801) lead was recalled after reports implicated lead fracture/retention wire protrusion in patient mortality and morbidity. Recent reports suggest that 801 lead extraction may be associated with substantial morbidity and, possibly, excess mortality. We hypothesized that the 801 lead could be extracted using the subclavian approach with a high success rate and acceptable morbidity.
We analyzed the clinical outcomes in 60 consecutive patients who underwent 801 lead extraction.
Sixty patients (34 women) with a mean age of 67 +/- 14.8 years had 18 class I, 13 class II, and 29 class III fractures. The lead age was 39 +/- 17 months. The subclavian approach was successful in 58 of 60 patients (96%). Complications, three major and eight minor, occurred in 10 of 60 patients (16%). All complications were successfully treated. There were no deaths. Only concurrent ventricular lead extraction was associated with complications (p = 0.008 by Fisher's exact test).
Telectronics 801 leads can be successfully extracted using the subclavian approach with acceptable short-term morbidity, low mortality, and excellent long-term results.
在有报告指出患者的死亡率和发病率与电极导线断裂/固定导线突出有关后，Telectronics 330 - 801心房J（801）电极导线被召回。近期报告提示，801电极导线拔除可能与显著的发病率相关，甚至可能与额外的死亡率有关。我们推测采用锁骨下途径拔除801电极导线成功率高且发病率可接受。
我们分析了连续60例接受801电极导线拔除患者的临床结局。
60例患者（34例女性），平均年龄67±14.8岁，有18例I级、13例II级和29例III级导线断裂。电极导线使用时间为39±17个月。60例患者中有58例（96%）采用锁骨下途径拔除成功。60例患者中有10例（16%）发生并发症，其中3例为严重并发症，8例为轻微并发症。所有并发症均成功治疗。无死亡病例。仅同时拔除心室电极导线与并发症相关（Fisher精确检验p = 0.008）。
采用锁骨下途径可成功拔除Telectronics 801电极导线，短期发病率可接受，死亡率低，长期效果良好。
