经食管超声心动图在心律植入装置经静脉电极导线拔除术中的应用评价

Evaluation of transesophageal echocardiography using for intraoperative transvenous leads extraction

目的评价经食管超声心动图(TEE)在心律植入电子装置(CIED)经静脉电极导线拔除术中的应用。方法回顾性分析2012年6月至2019年6月于北京大学人民医院行CIED经静脉电极导线拔除术中应用TEE监测患者的病历资料,分析并总结其在CIED经静脉电极导线拔除术中的重要作用。结果经静脉电极导线拔除术中放置TEE监测患者共102例。拔除224根电极导线,完全拔除219根(98%),部分拔除5根(残端>4 cm)。患者年龄(64.6±13.1)岁,70%为男性,体内电极导线(2.2±0.9)根,电极导线植入时间(154.7±71.7)月。102例患者应用TEE监测有指导意义的共12例(12%)。更改手术方式2例;诊断术中并发症8例(严重并发症5例,轻微并发症3例);指导后续相关治疗2例。结论TEE精确、时效的特点为临床医生提供重要信息,CIED经静脉电极导线拔除术中应用可保障手术安全。

Objective To evaluate the clinical utility of transesophagealechocardiography(TEE)during cardiovascular implantable electronic devices(CIED)transvenous leads extraction.Methods The perioperative data of patients who underwent leads extraction with TEE in the People′s Hospital of Peking University during June 2012 and June 2019 were retrospectively analyzed to summarize the important usage of TEE during transvenous leads extractions.Results Patients with TEE could reach up to 102 during transvenous leads extraction.Transvenous extraction of 224 leads was attempted:complete extraction was achieved for 219 leads(98%)and partial extraction for 5 leads with residual length>4 cm with clinically acceptable outcomes.Mean age of the patients was(64.6±13.1)years and 70%were male.The average number of leads per patient was 2.2±0.9.Mean implant duration was(154.7±71.7)months.Among the patients,12 cases showed specific guidance(12%)including altering surgical procedures(2 cases);diagnosing new onset complications during the operation(5 major complications,3 minor complications);instructing following therapy(2 cases).Conclusions TEE provides real-time and detailed information for clinician to guarantee the safety during CIED transvenous leads extraction.[Chinese Journal of Cardiac Pacing and Electrophysiology,2020,34(6):569-572]