[心脏上心脏起器感染通过通过重新切口切口去除头来治疗:病例报告]
Akira Hashino1, Hiroshi Kumano
1Department of Cardiovascular Surgery, Northern Okinawa Medical Center, Nago, Japan.
Kyobu geka. The Japanese journal of thoracic surgery
|July 15, 2024
概括
在发电机更换后心脏起器感染是具有挑战性的. 在体外循环下完全去除,成功治疗了心脏再同步治疗患者的复杂心脏起器感染.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
背景情况:
- 心脏起器感染带来了重大挑战,特别是在心脏病史复杂的患者中.
- 这一病例涉及一名69岁的女性,她有过 mitra 和三角置换病史,因左心室功能障碍而需要双心室节奏.
研究的目的:
- 描述在患有已建立心脏再同步治疗 (CRT) 系统的患者中,在发生器更换后的复发性心脏起器感染的管理.
- 为了突出在耐火起器感染的体外循环下进行完整的探的有效性.
主要方法:
- 最初的管理包括抗生素,发电机重新交换和口袋重新定位,这些都失败了.
- 随后的尝试包括临时节奏,移除受感染的发电机和新CRT-P植入.
- 最后的治疗是通过通过再切术在体外循环下去除,这是由于复发性感染和的形成.
主要成果:
- 尽管最初采取了保守和手术干预措施,但心脏起器感染再次复发.
- 胸部CT显示在前腹中的线索周围有一个.
- 在体外循环下完全去除导致了无事件的术后过程和6年的无感染生存.
结论:
- 耐火性心脏起器感染,特别是在形成时,可能需要彻底的手术方法.
- 在重新切口术期间,体外循环可以成为完全去除受感染起器导线的拯救生命的选择.
- 成功管理复杂的心脏起器感染可以确保长期的患者福祉和设备功能.
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