由右心室隔膜起器引发的左心室自由壁穿孔引起的延迟心脏坦波纳德:一个病例报告
Ryo Nishinarita1, Kenshiro Arao1, Kei Akiyoshi2
1Department of Cardiovascular Medicine, Nerima Hikarigaoka Hospital, Nerima, Japan.
Journal of cardiology cases
|July 23, 2025
概括
在右心室 (RV) 隔膜中植入的起器线意外地穿透了左心室自由壁 (LVFW),导致心脏坦波尼德延迟. 手术提取和重新定位是成功的,突出了需要小心地放置的需要.
科学领域:
- 心脏病学 心脏病学
- 医疗器械并发症 医疗器械并发症
- 心脏外科手术 心脏外科手术
背景情况:
- 双腔心脏起器植入是症状性心动减速-心综合征的常见程序.
- 在高隔膜中放置右心室 (RV) 是标准的技术.
- 尽管很少见,但在植入心脏起器后可能会出现并发症.
研究的目的:
- 报告一个罕见的左心室自由壁穿孔延迟的病例,由RV隔膜.
- 讨论这种并发症的诊断结果和管理.
- 强调解剖学理解和适当的领导管理在心脏起器植入中的重要性.
主要方法:
- 一名70岁的男性患者患有症状性心动减速-心综合征,接受了双室心脏起器植入.
- 起初,RV导线被放置在RV高隔膜中.
- 计算机断层扫描 (CT) 发现左心室自由壁 (LVFW) 穿孔;进行了开放胸部手术以提取和更换.
主要成果:
- 在植入后两个月,RV穿透了LVFW,延伸到RV隔膜和左心室内壁.
- 血的心周溢出源于RV静脉血液,导致心脏穿孔.
- 通过手术提取穿孔的,合伤口,并重新插入新的RV顶,成功完成了手术.
结论:
- 这一案例突出了一个罕见的延迟心脏坦波纳德的例子,原因是LVFW由RV隔膜穿孔.
- 准确的位置和对心脏解剖学的彻底了解对于预防此类不良事件至关重要.
- 开放式外科手术是管理无LV壁穿孔和相关心脏栓塞的首选方法.
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