Kimura T, Chiba Y, Ihaya A, Tsuda T, Sasaki H, Muraoka R
Second Department of Surgery, Fukui Medical School, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Mar;46(3):299-302. doi: 10.1007/BF03217745.
A case of breakage and removal of a retained transvenous pacemaker electrode is described. A 22-year-old woman with complete A-V block underwent implantation of a transvenous pacemaker system on the left anterior chest wall in 1989. Three years later, a new generator was implanted on the right chest wall because of local infection of the pacemaker pockets. The old electrodes could not be removed and were left in place. Beginning in 1995, the patient complained of anterior chest pain. A chest roentgenogram revealed that one of the pacemaker electrodes had broken at the right costoclavicular ligament and a fragment was floating in the superior vena vava. The retained electrodes were removed under tot cardiopulmonary bypass. These electrodes had become firmly encased with fibrous tissue within the right ventricle and atrium, but they were easily removed under direct vision duting complete cardiac arrest. The postoperative course was uneventful and the patients had no further complaint.
本文描述了一例留存的经静脉起搏器电极断裂并取出的病例。一名22岁完全性房室传导阻滞女性于1989年在左前胸壁植入经静脉起搏器系统。三年后，因起搏器囊袋局部感染，在右胸壁植入了新的发生器。旧电极无法取出，留在了原位。从1995年开始，患者主诉前胸疼痛。胸部X线片显示，一根起搏器电极在右肋锁韧带处断裂，一块碎片漂浮在上腔静脉内。在全心肺转流下行留存电极取出术。这些电极已在右心室和心房内被纤维组织牢固包裹，但在心脏完全停搏直视下很容易取出。术后病程平稳，患者无进一步不适主诉。
