Safak Alpat, Ahmet Aydin, Uğur Canpolat, Mustafa Yilmaz
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引用次数: 0
摘要
需要三尖瓣置换术(TVR)的患者通常需要永久性经瓣起搏器(PM)导联,这对导联管理提出了重要挑战。目的:本研究的目的是评估在TVR手术中永久起搏器导联的瓣旁定位的结果。材料和方法:2014年至2024年间,共有15例先前使用经静脉起搏器系统的患者接受了TVR。回顾性收集了相关信息,重点是起搏器特征。结果:在研究期间,共有15例先前植入PM铅的患者接受了TVR。起搏器植入和TVR的中位时间间隔为8.5年(5.7-10.5年)。术前阈值中值振幅和阻抗分别为1 V (0.68-1.25 V)和518 Ω (377.5-598.7 Ω),术后阈值中值振幅和阻抗分别为0.73 V (0.5-1 V)和460 Ω(378.5-550)。在中期随访期间,没有患者死亡或显著发病率,也没有患者需要调整起搏器导联。结论:我们的结论是,在TVR手术中,瓣旁定位PM导联是一种可接受的选择,因为这种技术在中期随访中可以更好地发挥假瓣膜和起搏器的功能。
Paravalvular positioning of a cardiac implantable electronic device electrode during tricuspid valve replacement.
Introduction: Patients who need tricuspid valve replacement (TVR) surgery often have permanent transvalvular pacemaker (PM) leads, which pose an important challenge in lead management.
Aim: The objective of this study was to evaluate the results of paravalvular positioning of a permanent pacemaker lead during TVR surgery.
Material and methods: Between 2014 and 2024, a total of 15 patients who had previously had a transvenous pacemaker system underwent TVR. Relevant information, with a focus on pacemaker characteristics, was collected retrospectively.
Results: A total of 15 patients with PM lead previously implanted underwent TVR during the study period. The median time interval between pacemaker implantation and TVR was 8.5 years (5.7-10.5 years). The preoperative median threshold amplitude and impedance values were 1 V (0.68-1.25 V) and 518 Ω (377.5-598.7 Ω), whereas the postoperative median threshold amplitude and impedance values were 0.73 V (0.5-1 V) and 460 Ω (378.5-550). During the midterm follow-up, there were no mortalities or significant morbidities, and no patients required pacemaker lead revision.
Conclusions: We concluded that paravalvular positioning of the PM lead is an acceptable option during TVR surgery, since this technique enables better function of the prosthetic valve and pacemakers at mid-term follow-up.
期刊介绍:
Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.