左上腔静脉畸形与心脏起搏  

Cardiac pacing in the presence of left superior vena cava

作　　者：冯义柏[1] 曹林生[1] 于世龙[1] 刘幼文 李裕舒[1] 曾秋棠[1] 雷鸣 曾彪 吴桂芳[1] 李刚 

机构地区：[1]同济医科大学心血管病学研究所,430022

出　　处：《临床心血管病杂志》1994年第1期15-16,共2页Journal of Clinical Cardiology

摘　　要：在269例行心脏起搏的患者中,发现7例(2.6%)伴有左上腔静脉(LSVC)畸形,其中1例为完全性房室传导阻滞,6例为病态窦房结综合征.5例植入永久人工心脏起搏器,电极由LSVC下行进入右心房,但进入右心室固定极为困难.在证实同时伴有右上腔静脉(RSVC)后,4例改由右侧插入电极,另1例经调整电极插入方向越过了LSVC和RSVC间的交通支,均通过RSVC入右心房,成功固定于右心室尖部.本文对此类患者的临床特点及其处理进行了讨论.Seven (2. 6%) patients with left superior vena cava were encounted in 269 consecutive patients who were paced. Six of 7 patients were with sick sinus syndrome, one with complete A-V block. In 5 of 7, a permanent electrode was tried to insert through left cephalic.or subclavian veins, but it was found to bevery difficult to pass through the left superior vena cava, introduce into and fix in right ventricular apex. After presence of a patent right superior vena cava was proved, right side was changed for left side to insert electrode in 4 cases. The electrode of other one case was inserted into right superior vena cava through connection between the left and right superior vena cava still from left side. Implantion of permant electrodes of all 5 patients were successful. The present result, as finding of some authors, suggests that sinus node dysfunction may be associated with anomalousleft superior vena cava of return to heart, which often results in failure of implantion of transvenous electrode. Their clinical feature and management were reviewed.

关 键 词：左上腔静脉 心脏起搏 畸形 

分 类 号：R654.2[医药卫生—外科学]