小児期ペースメーカー植え込み症例の検討 : 特にジェネレーターポケット部位について

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Twenty patients aged 5 days to 14 Years underwent implantation of cardiac pacemakers and were followed up for an average of 6 years (range 8 months to 6 years and 2 months) . Complete heart block was present in 17 patients and sinus nodal dysfunction in three. The etiology of heart block was surgical in 14 cases, congenital in three. Five patients had symptoms of cardiac failure and one had syncopal attack. Pacing was required in 14 patients for postoperative rhythm control. One patient died of prosthetic valve malfunction after 11 months of pacing. Others are all alive and well. The VVI mode was used in all. For lead insertion, a left anterolateral thoracotomy was used in 19 patients, a sternotomy in one. The pacemaker generator was implanted in extrapleural space in five cases, and beneath the fascia of the left upper abdominal rectal muscle in 15. As complications of pacemaking, infection occured in three, lead fracture in two, high pacing threshold in two and muscle twich in one. No difference was noted in the incidence of complications between the two implantation sites. The intrathoracic implantation presented technical difficulties at the time of generator change compared to the implantation in the abdominal wall. We consider that the implantation beneath the fascia of abdominal rectal muscle is a procedure of choice for infants and children in whom repeated generator changes are required in the future.
日本小児外科学会の論文
1990-06-20

小児期ペースメーカー植え込み症例の検討 : 特にジェネレーターポケット部位について

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