永存左上腔静脉畸形患者行起搏器植入术研究分析

目的 对永存左上腔静脉畸形患者行起搏器植入方法及术后起搏功能作初步探讨.方法 分析13例永存左上腔静脉畸形植入心脏起搏器患者的导线植入路径、方法、导线植入位置、手术与X线曝光时间.结果 13例患者中5例经左锁骨下静脉径路,8例经右锁骨下径路植入导线,均获成功.右侧血管径路与左侧血管径路植入起搏器X线曝光及手术时间比较差异有统计学意义：（593.61±70.03）s对（948.45±69.06）s,P＜0.001及（53.49±5.11） min对（81.25±13.39） min,P＜0.001.随访4～89个月,起搏功能良好.结论 对左上腔静脉永存伴（或不伴）右上腔静脉缺如的患者植入起搏器,通过选择合适的路径、恰当的起搏模式、操作手术均能获得成功,近期和远期随访结果满意.

Permanent pacemaker implantation in patients with persistent left superior vena cava

Objective To investigate the implantation and function of permanent pacemaker in patients with persistent left superior vena cava （PLSVC）.Methods Access,method,and position of lead implantation and x-ray exposure time during procedure were analyzed in 13 consecutive patients with PLSVC.Results Leads were implanted via the left subclavian vein in 5 of the 13 patients （38.5%） and via the right subclavian vein in the other 8 patients.X-ray exposure time and procedure time of the left subclavian access were both significandy shorter than those of the right subclavian access （593.61 ± 70.03） s vs （948.45± 69.06） s,P 〈 0.001 ; （53.49±5.11） min vs.（81.25± 13.39） min,P〈0.001.The pacemakers functioned well during a mean follow up period of （55.84±26.07） months.（4 to 89 months）.Conclusion Pacemaker can be successfully implanted by carefully choosing the appropriate access in PLSVC patients with or without absence of right superior vena cava.Both short term and long term follow up results were favorable.