経静脈性カテーテル電極による右室穿孔に対する緊急手術の1例

Surgical Treatment of Right Ventricular Perforation by a Transvenous Electrode Catheter；Report of a Case

はじめに　経静脈的ペーシングの際，挿入に伴う穿孔や心タンポナーデなどの合併症が報告されている1～2）．われわれは，カテーテル電極挿入後9日目に疼痛により発見された右室心尖部穿孔例を緊急手術によって救命したので，若干の文献的考察を加えて報告する．

We report a case of surgical treatment of iatrogenic right ventricular perforation. An 86-year-old woman with sick sinus syndrome was treated by insertion of transvenous electrode catheters. She was transferred to our hospital due to chest pain 9 days after the insertion. We found the ventricular electrode catheter had perforated the right ventricle by computed tomography （CT）. This perforated lesion was repaired under beating heart using 2-0 monofilament mattress sutures reinforced by felt pledgets. The perforation may have occurred because the apex portion of the right ventricle was fragile. Iatrogenic cardiac trauma is rare, and prompt recognition and treatment are essential.