Kemal Göçer, Halil İbrahim Yıldırımdemir

Kardiyak Tamponad ile Başvuran Çok Geç ve Subakut Sağ Ventriküler Lead Perforasyonu

Ventriküler lead perforasyonu (VLP), kalıcı kalp pillerinin nadir görülen ve hayatı tehdit eden bir komplikasyonudur. Genellikle VLP, kardiyak elektronik cihazlar implante edildikten sonra akut ve subakut dönemlerde ortaya çıkar. Geç VLP alışılmadık bir durumdur ve daha az sıklıkla meydana gelir. VLP'lerin tedavisine yönelik belirsiz bir yaklaşım vardır. Kardiyovasküler cerrahlarla işbirliği önerilir. Burada başarıyla tedavi edilen iki kardiyak perforasyon vakasını sunuyoruz. Bunlardan biri çift odacıklı kalp pili (DCP) implantasyonundan dört yıl sonra kalp tamponadı ile başvurdu ve sağ ventrikül lead'i açık cerrahi yöntemle başarıyla çıkarıldı. Diğeri, DCP implantasyonundan iki hafta sonra kardiyak tamponad ile kabul edildi. Ventriküler lead, cerrahi destek olmaksızın basit bir traksiyon yöntemiyle çıkarıldı ve doğru yere başarıyla yeniden implante edildi.

Very Late and Subacute Right Ventricular Lead Perforation Presenting as Cardiac Tamponade

Ventricular lead perforation (VLP) is a rare and life-threatening complication of permanent pacemakers. Generally, VLP emerges in acute and subacute periods after cardiac electronic devices are implanted. Late VLP is unexpected and occurs less frequently. There is an uncertain approach to the treatment of VLPs. Collaboration with cardiovascular surgeons is recommended. Herein, we present two cases of cardiac perforations who were successfully managed. One of them was admitted with cardiac tamponade four years after dual-chamber pacemaker (DCP) implantation, and the right ventricular lead was successfully removed with an open surgical method. The other was admitted with cardiac tamponade two weeks after DCP implantation. Ventricular lead was extracted by a simple traction method without surgical support and successfully re-implanted in the correct location.

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