A Case of Myocardial Lead Fixation via a Small Costal Bed Thoracotomy Approach under Local Anesthesia
10.4326/jjcvs.33.255
- VernacularTitle:局所麻酔下肋骨床小切開アプローチによる心筋電極縫着によりペースメーカー再植え込みが可能であった１例
- Author:
Satoru Okumura
;
Yoshinobu Maeda
;
Jun Okawara
- Publication Type:Journal Article
- Keywords:
MRSA
- From:Japanese Journal of Cardiovascular Surgery
2004;33(4):255-258
- CountryJapan
- Language:Japanese
-
Abstract:
The patient was an 86-year-old man, whose medical history included pulmonary tuberculosis, pulmonary emphysema, hypothyroidism, subtotal gastrectomy for gastric cancer and proctectomy for rectal cancer. Since he suffered sick sinus syndrome (bradycardia-tachycardia syndrome), a DDD pacemaker was implanted using the right subclavian vein approach. Three months later, he suffered from a pacemaker infection of Methicillin-resistant Staphylococcus aureus. We performed extraction of the infected pacemaker system and implanted a new pacemaker. Because he had thoracic deformity, colostomy, and was in poor condition in general, we implanted the myocardial electrode through a small thoracotomy at the 6th costal bed under local anesthesia. The postoperative course was uneventful and there was no relapse of infection. Although this method is conventionally performed under general anesthesia, it is also possible to perform it under local anesthesia in selected patients. This method could be an alternative when endocardial electrode insertion is very difficult.
