通过静脉输入的的管理在患有Iatrogenic穿孔的患者
Arwa Younis1, Ameer Awashra1, Maria Matteo1
1Cardiac Electrophysiology Section, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Journal of cardiovascular electrophysiology
|September 9, 2025
概括
通过皮肤去除导致穿孔的心脏植入式电子设备线是安全有效的. 在电生理学实验室的经验丰富的操作人员可以成功地管理这些罕见的并发症,最小的不良事件.
科学领域:
- 心脏病学 心脏病学
- 干预心脏病学 干预心脏病学
- 医疗器械并发症 医疗器械并发症
背景情况:
- 阴性穿孔是心脏植入式电子设备 (CIED) 植入的罕见但严重的并发症.
- 有限的证据表明,通过皮肤管理亚急性或延迟的穿孔病例.
研究的目的:
- 评估通过皮肤管理的可行性和安全性,以治疗亚急性或延迟的阴性穿孔.
- 在这种情况下,分析临床表现,程序方法和除的结果.
主要方法:
- 在2012年1月至2024年10月期间,对38名因阳性穿孔 (不包括急性病例) 接受治疗的患者进行了回顾性审查.
- 在成像指导下在电生理学 (EP) 实验室或带有手术备用的混合手术室 (OR) 中进行的除.
- 对临床表现,成像,程序方法和结果的分析.
主要成果:
- 在EP实验室对25名患者进行了除,在OR中对13名患者进行了除.
- 大多数穿孔线都是心脏起器线 (58%),通常涉及右心室 (72%).
- 在所有患者中,完整的切除和重新植入都取得了成功;在8%的患者中,需要心脏凝聚,在中位数16个月的随访中没有重大并发症或延迟事件.
结论:
- 在电生理学实验室中,通过皮肤去除穿孔导线是可行的和安全的策略,如果由经验丰富的操作人员进行.
- 由于穿孔并发症的潜在严重性,手术备份的可用性至关重要.
- 这种方法提供了一种可行的解决方案,用于管理延迟的阴性穿孔.
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