- 期刊
經靜脈移除附著一大型贅生物之心臟節律器導線感染－一病例報告
Transvenous Lead Removal of Pacemaker Lead Infection with a Large Vegetation-A Case Report
摘要
心律調節霧導線感染是裝置心律調節霧的併發症之一，如果延遲處理，可能預後不良。根據報導，死亡率爲30%至35%。如果僅使用抗生素而不移除心律調節霧，復發率爲100%。移除心律調節霧導線的方法包括外科開心手術和經靜脈移除心臟節律霧導線。如果術前經食道心臟超音波檢查，三尖瓣沒有受損，即使贅生物超過10mm，經靜脈移除心臟節律器導線仍是安全有效的方法。本文報告了一位心律調節器導線感染的73歲女性，經食道心臟超音波發現在心律調節器的導線上有1.55x1.71cm的贅生物，以抗生素以及經靜脈移除導線治療成功。藉以提醒臨床醫師心律調節器心內膜炎的重要性以及經靜脈移除導線的可行性。
並列摘要
Pacemaker lead infection is one of complication after pacemaker implantation, associated with poor prognosis if treatment is delayed. Mortality rate have been reported to be 30 to 35%. Relapse of pacemaker endocarditis is 100% if patients were treated with antibiotics alone. The methods of pacemaker lead removal including open heart surgery and transvenous pacemaker lead removal. If tricuspid valve destruction is abscent in preoperative TEE, transvenous pacemaker lead removal is an effective and safe procedure even if vegetations are greater than 10mm. This report described a 73-year-old female patient who developed pacemaker endocarditis and transesophageal echocardiography revealed a 1.55×1.71cm vegetation at pacemaker lead and treated successfully by antibiotics and transvenous pacemaker lead removal. We emphasized the importance of pacemaker endocarditis and the feasibility of transvenous pacemaker lead removal.
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