心脏手术后临时心外膜起搏导线不完全移除及意外保留1例报告

Q4 Medicine
A. Khalili, A. Jodati, Mehran Rahimi, Amir Faravn, Razieh Parizad
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引用次数: 0

摘要

临时起搏器导线常用于术后急性期心律失常的诊断和治疗。我们在此描述一位65岁的女性,有冠状动脉搭桥手术史,在使用抗生素时,胸骨下三分之一处有脓性分泌物。两年后,治疗失败,切除了2根胸骨线。手术几年后,病人出现脓性分泌物。怀疑为肋骨骨髓炎,切除与胸骨相连的最后一块左软骨,并切除感染性道。术中右心室撕裂,用卫生棉条止血。患者经左股动脉和右股静脉插管行体外循环。打开胸骨,修复破裂部位。在右心室破裂处发现一根临时心外膜起搏导线。几天后,由于左腹股沟搏动性血肿和股动脉假性动脉瘤的诊断,患者从重症监护病房被送到手术室。一周后,下胸骨脓性分泌物好转,患者出院。出院后随访1个月,感染被根除。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incomplete Removal and Accidental Retention of Temporary Epicardial Pacing Wires in the Chest after Heart Surgery: A Case Report
Temporary pacemaker wires are commonly used for the diagnosis and treatment of arrhythmias in the acute postoperative period. We herein describe a 65-year-old woman with a history of coronary artery bypass graft surgery who was referred to the hospital with a purulent discharge in the lower third of the sternal region while on antibiotics. Two years later, following treatment failure, 2 sternal wires were removed. Several years after the surgery, the patient developed a purulent discharge. On suspicion of rib osteomyelitis, the last left cartilage attached to the sternum was excised and removed together with an infectious tract. During the operation, the right ventricle was torn, and tampons were used to control bleeding. The patient was placed under cardiopulmonary bypass via the cannulation of the left femoral artery and the right femoral vein. The sternum was opened, and the rupture site was repaired. A temporary epicardial pacing wire was found at the site of the right ventricular rupture. Several days later, the patient was taken from the intensive care unit to the operating room due to a pulsatile hematoma in the left groin and a diagnosis of a pseudoaneurysm of the femoral artery. After a week, the purulent discharge at the lower sternum improved, and the patient was discharged. At 1 month’s post-discharge follow-up, the infection was eradicated.
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来源期刊
Journal of Tehran University Heart Center
Journal of Tehran University Heart Center Medicine-Cardiology and Cardiovascular Medicine
CiteScore
0.90
自引率
0.00%
发文量
46
审稿时长
12 weeks
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