设备植入复杂的由一个后侧囊复杂装置植入
Sally Elshafie1, Abu Taher Tariq1, Francisco Leyva Leon2
1Cardiology Department, University Hospitals of Derby and Burton, Derby, UK.
Pacing and clinical electrophysiology : PACE
|August 18, 2023
概括
来自背侧的中央静脉阻塞是罕见的. 该案例详细介绍了由于静脉封闭而导致的具有挑战性的心脏植入式电子设备植入,需要使用替代的股骨静脉方法.
科学领域:
- 心脏病学 心脏病学
- 血管外科 血管外科
背景情况:
- 中枢静脉阻塞是心脏植入式电子设备 (CIED) 的常见并发症,通常是由线索的血栓形成或纤维化引起的.
- 在CIED植入之前静脉封闭是不常见的,后侧子是潜在的原因.
研究的目的:
- 报告一个独特的CIED植入病例,该病例发生在患有双侧关节下静脉塞的患者身上,该病例是由后侧引起的.
- 描述一种替代的植入策略,当标准CIED程序由于解剖障碍而不可行时.
主要方法:
- 一个左心室功能受损的患者和需要心脏再同步治疗 (CRT) 的莫比茨II型心脏阻塞,由于背侧,出现了双侧下静脉封闭.
- 进行了多次失败的尝试,用于CRT,双室心脏起器和左捆分支区域节奏 (LBBaP).
- 终于通过右大腿静脉植入了一个单心脏起器.
主要成果:
- 背侧带导致双侧下静脉的完全封闭,阻止了标准的CIED位.
- 通过常规或替代步调部位 (LBBaP) 无法满足患者对CRT的指示.
- 成功植入心脏起器是通过较少使用的,通过大腿静脉通过静脉输入的方法实现的.
结论:
- 背侧可以导致显著的中央静脉阻塞,使CIED植入复杂化.
- 当标准路线受到损害时,异常的静脉接入,例如大腿静脉,可能是必要的.
- 这一案例凸显了考虑静脉阻塞异常病因的重要性,并相应地调整植入策略.
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