■植入心脏可植入电子设备是一种全球公认的治疗心律失常的疗法,并发症发生率低。除了技术问题,然而,植入材料可能会引起并发症。这会导致出血,感染,或者发生器口袋的慢性刺激,导致肿胀,血清学,穿孔,或瘘管。然而,组织变化的原因并不总是很清楚,因此,我们想报告一个病人诊断出的罕见组织变性。
■有室颤病史后,一名46岁的患者接受了植入式心律转复除颤器(ICD)的二级预防.六年后,发生器袋膨胀,没有感染的迹象。怀疑诊断出慢性刺激的口袋,该装置随后被手术重新安置。经过2年的无症状期,患者再次出现严重肿胀但只有轻微疼痛的装置袋。再一次,没有感染的迹象,所以口袋又被修改了,假设慢性刺激性积液。术中,从胸下ICD口袋出现脂肪瘤结构(12×6×3cm)。在其完全移除之后,组织病理学检查显示为脂肪瘤。微生物样本可以排除细菌的起源,伤口愈合良好,没有进一步的不适。
■这种情况表明,慢性刺激发生器口袋的原因,除了通常已知的组织变化,也可以是肿瘤。因此,切除的组织应进行组织病理学检查,如果指示,启动特定治疗。
UNASSIGNED: The implantation of cardiac implantable electronic devices is a globally established therapy to treat cardiac arrhythmias with low complication rates. Apart from technical problems, however, complications can arise from the implanted material. This can lead to bleeding, infections, or chronic irritation of the generator
pocket, resulting in swellings, seromas, perforations, or fistulas. However, the cause of tissue changes is not always clear, and therefore, we would like to report on a rare tissue degeneration diagnosed in a patient.
UNASSIGNED: After a history of ventricular fibrillation, a 46-year-old patient received an implantable cardioverter-defibrillator (ICD) for secondary prevention. Six years later, the generator
pocket swelled without evidence of infection. With the suspected diagnosis of a chronically irritated
pocket, the device was then surgically relocated. After a 2-year symptom-free period, the patient presented again with a severely swollen but only slightly painful device pocket. Once again, there were no signs of infection, and so the
pocket was revised again, assuming a chronic irritant effusion. Intraoperatively, a lipomatous structure (12 × 6 × 3 cm) emerged from the subpectoral ICD
pocket. After its complete removal, the histopathological examination revealed a lipoma. A bacterial genesis could be ruled out by microbiological samples, and the wound healed cosmetically well and without further discomfort.
UNASSIGNED: This case shows that the reason of chronically irritated generator pockets, in addition to the usually known tissue changes, can also be tumours. Therefore, resected tissue should be examined histopathologically and, if indicated, specific therapy initiated.