一例延迟的右心室节拍器与相关的穿孔导致心脏吸血栓的病例
Yuhi Nakamura1, Motohiro Kawauchi1, Yuki Tanaka1
1Department of Cardiovascular Surgery, Kanto Rosai Hospital, Kawasaki, JPN.
Cureus
|October 7, 2025
概括
延迟心脏起器孔是一个罕见但严重的并发症. 这一案例突出了紧急手术修复和心脏吸管的管理,强调了潜在的保留策略.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 心脏外科手术 心脏外科手术
背景情况:
- 通过心脏起器导线进行右心室穿孔是一种已知的并发症.
- 延迟穿孔 (>植入后1个月) 是罕见的,缺乏明确的治疗策略.
- 穿孔延迟可能导致危及生命的疾病,如心脏坦波纳德.
研究的目的:
- 报告一个延迟的右心室穿孔导致心脏坦波尼德的病例.
- 讨论这种罕见并发症的管理和治疗策略.
- 突出诊断和领导管理决策过程中的挑战.
主要方法:
- 一个60岁的男性病例报告,有心脏起器植入的病史.
- 呈现胸部疼痛,背部疼痛和由于心脏吸管而引起的呼吸不良.
- 紧急中间椎切除术用于心周液排水和血流控制,与保留和修复.
主要成果:
- 心脏吸管被诊断为右心室孔的次要原因.
- 紧急手术成功地控制了吸管,并修复了穿孔.
- 由于稳定的电气参数,最初保留了穿孔,随后调整了心脏起器设置.
- 患者康复良好,并已出院.
结论:
- 延迟的起器孔需要及时识别和管理.
- 由于穿孔引起的心脏吸管可能需要进行手术.
- 保留与密切监测和潜在的临时植入是一个可行的策略,当移除/重新插入是不可行的或立即指示.
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