在管切除过程中的心内血瘤,用于与痕相关的风性心动节拍
Roy M John1, Usha Tedrow2, Thomas Tadros2
1Stanford University, Palo Alto, California, USA.
JACC. Clinical electrophysiology
|August 26, 2023
概括
内腔血瘤是痕相关的腹腔动心 (VT) 的切除过程中的罕见,危险的并发症. 及时识别和手术干预通常可以为这种静脉管切除并发症挽救生命.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗并发症 医疗并发症
背景情况:
- 内腔血瘤是痕相关的腹腔动心 (VT) 的切除手术期间罕见但危及生命的并发症.
- 了解这种并发症的特征和结果对于患者的安全至关重要.
研究的目的:
- 描述与痕相关的静脉瘤在切除过程中发生的静脉内血瘤的特征和结果.
- 为了确定与这种罕见并发症相关的模式和危险因素.
主要方法:
- 两所机构在2010年至2022年间进行的超过3,514次VT废除的回顾性审查.
- 对四个已确定的内壁血瘤病例的手术细节,成像数据和手术笔记的分析.
- 程序事件的相关性,如蒸汽弹和导管类型,与血液瘤的形成.
主要成果:
- 在4例中,有3例在导管切除过程中发生了内腔血瘤,通常是蒸汽爆发之前.
- ST细分段升高和心内心声谱发现是关键诊断指标.
- 需要排水的心周溢出发生在3例病例中;手术干预在2例病例中取得了成功,但一名患者死于心脏性休克.
结论:
- 在静脉切除过程中,静脉内血瘤是一种罕见的,潜在的灾难性并发症,需要及时识别.
- 蒸汽爆发是血液瘤形成的常见前体.
- 手术干预可以挽救生命,尽管对于封闭性血液瘤来说,保守的管理是可能的.
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