摘要
经静脉造影或观察导丝走形证实 6例患者存在静脉畸形、迂曲、狭窄 ,其中 5例高龄患者置入永久起搏器时 ,其上腔静脉系统迂曲、狭窄 ,无法使用起搏器穿刺套装内的导丝及鞘管将导线送到起搏部位 ,另 1例为永存左上腔静脉合并有右上腔静脉缺如。试用 175cm 0 .0 35长导丝以及 6 8FINPUT鞘替代普通起搏器穿刺套装。结果 :使用175cm 0 .0 35长导丝以及 6 8FINPUT鞘顺利地将起搏导线送入右心房中下部 ,安全地完成置入手术 ,无并发症。结论 :一旦送入导线或导丝困难 ,应积极地进行血管造影 ,不应盲目的推送 ,使用 175cm长导丝增加支撑力 ,结合IN PUT鞘管通过狭窄或纡曲延长的血管段 ,给起搏导线提供一个光滑的通道 ,可顺利的将起搏导线送入心房及心室。
This study included 5 elderly patients in whom the pacemaker implanted procedures failed because the common guide wires and or sheathes supplied by pacemaker company could not be advanced into their tortuous,prolonged superior caval veins.Another patient suffered from congenital absence of right superior vena cava and a persistent left superior vena cava.AVE INPUT sheath and standard 0.035×175cm guide wire were used in these patients try to solve such problems.The pacemaker implanted procedures were success in all the patients without complications.In case the guide wire or electrode leads could not be advanced through superior caval vein,angiographies should be done immediately to find abnormal or anomaly vessels.AVE INPUT sheath combined with standard 0.035×175 cm guide wire could provide extra support and smooth channel which may be useful to advance the leads through tortuous,prolonged or anomaly superior caval vein into atrium.
