アブレーションカテーテルが左室内で抜去困難となり外科的摘出を行った1例

Open Heart Surgery to Remove an Ablation Catheter Entrapped in the Left Ventricle；Report of a Case

はじめに　経皮的カテーテルアブレーションは，頻脈性不整脈の原因となる心筋組織をカテーテルで焼灼する手技である1）．合併症発生率は3.7％と報告されており，治療に手術が必要となるような重篤な合併症はさらにその7～10％と少ない2，3）．われわれはカテーテルが僧帽弁後尖の複数のbasal chordaeに巻絡し，開心術下にカテーテル抜去を要した症例を経験したので報告する．

A 66-year-old man underwent catheter ablation for Wolff-Parkinson-White syndrome. When we advanced the ablation catheter clockwise in the left ventricle, it was entrapped and became unable to control. Thus, the patient underwent open heart surgery for catheter removal. During the surgery, the last few millimeters of the catheter were observed entrapped by multiple basal chordae of the posterior mitral valve. We released the catheter safely, and visual inspection of the left ventricle showed no abnormalities. His postoperative course was uneventful. Ablation catheter entrapment in the heart is a rare but severe complication that requires open heart surgery.