Infecciones en el sistema de marcapasos. Extracción de electrodos. Estimulación permanente por vía femoral

García, Javier de Santiago; García, Jesús Rodríguez; Guerrero, Juan José García

doi:10.1016/s1131-3587(07)75266-4

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…The number of intracardiac stimulation device interventions is increasing because of the expanded indications for cardiac stimulation and defibrillation. The related increase in complications 16 points towards a growing need for alternatives to the upper access approach 17,18 . When the upper access approach is not possible or not recommended for other reasons, an epicardial system is usually implanted, even though this procedure requires general anaesthesia, is a more aggressive surgical option and leads to worse longterm results than endocardial systems in patients with cardiovascular disease 1 and congenital heart disease 19 .…”

Section: Discussionmentioning

confidence: 99%

Use of the transfemoral access approach for cardiac stimulation device implantation when the superior venous approach is not feasible: A single-centre twenty-year series

Guerrero,

Castañeda,

Piñero

2024

MRAJ

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Background: When permanent cardiac stimulation device implantation via superior venous access (i.e., cephalic, axillary or subclavian veins) is not possible or advisable, safe and feasible surgical alternatives must be used. The transfemoral approach is relatively unknown; therefore, it is seldom used and studied. This single-centre study analysed the 20-year outcomes of patients who underwent implantation using a transfemoral implantation approach. Methods: Data on the implantation procedure (indication, approach, lead and pacemaker models, complications), patient characteristics (age, sex, medications, comorbidities), and follow-up were analysed for all patients who underwent permanent cardiac stimulation device implantation using the transfemoral approach between June 2001 and December 2021. Results: A permanent cardiac stimulation device was implanted using the transfemoral approach in 66 patients (mean age, 76 years [range: 45-96], 40 [60%] men). The most frequent indication was atrioventricular block, associated with sinus rhythm in 36 patients and atrial fibrillation in 11 patients. The mean implantation time was 61 min (range: 20-210), and the mean fluoroscopy time was 7.9 min (range: 0.2-87). The minimum follow-up period was one year (December 2022), with a mean of 60 months [range: 2-180]). Overall, 26 patients (42%) were treated with oral anticoagulants postimplantation. No deaths, septic episodes, or severe complications were associated with the procedure in the short or long term. Follow-up data were available for 64 patients, of whom 52 (81%) died during follow-up (mean age, 84 years [range: 55-101]). No deaths were associated with the use of the transfemoral technique. Conclusions: Permanent cardiac stimulation device implantation using the transfemoral access approach is feasible and straightforward for an experienced implant surgeon. The outcomes of systems implanted by the transfemoral access approach were comparable to those of systems implanted by the superior venous approach, and no severe complications were observed at the 20-year follow-up.

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Section: Discussionmentioning

confidence: 99%

Use of the transfemoral access approach for cardiac stimulation device implantation when the superior venous approach is not feasible: A single-centre twenty-year series

Guerrero,

Castañeda,

Piñero

2024

MRAJ

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“…The number of intracardiac device interventions is increasing as a consequence of the expanded indications for cardiac stimulation and defibrillation. The related increase in complications point toward a growing need for alternatives to upper access . When the upper access is not available or not recommended for other reasons, an epicardial system is usually implanted, even though this procedure requires general anesthesia, is a more aggressive surgical option, and delivers worse long‐term results than those obtained with endocardial systems in cardiovascular disease and congenital heart disease .…”

Section: Discussionmentioning

confidence: 99%

Transfemoral access when superior venous approach is not feasible equals overall success of permanent pacemaker implantation. Ten‐year series

Guerrero

Castañeda

Calatrava

et al. 2017

Pacing Clinical Electrophis

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“…profundización del generador, tiene buenos resultados siempre que se trate de infecciones locales y no esté implicado el germen S. aureus 7,8 . En nuestra serie, la profundización subpectoral está poco representada ya que a la mayoría de los pacientes se les realizó una nueva bolsa subcutá-nea.…”

Section: Discussionunclassified

Evolución de los pacientes con complicaciones locales en la bolsa del generador de un dispositivo implantable

Izquierdo¹,

Bonanad²,

Madrazo³

et al. 2014

Archivos de Cardiología de México

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Recibido el 15 de febrero de 2013; aceptado el 24 de octubre de 2013 PALABRAS CLAVEMarcapasos; Infección; Endocarditis; España ResumenObjetivo: Las recomendaciones para la extracción completa de la bolsa de dispositivos implantables por problemas locales han cambiado. Analizamos la evolución entre 2002 y 2010 de los pacientes que requirieron una intervención por una complicación local en nuestro centro. Métodos: Ochenta y tres pacientes tuvieron un problema local de la bolsa que se clasificó según integridad de la piel: 1. Íntegra y 2. Abierta, y el tipo de intervención realizada: 1. Conservadora, 2. Extracción parcial y 3. Extracción completa. El objetivo primario fue la necesidad de reintervención posterior y la de extracción total durante el seguimiento. Resultados: El grupo de pacientes con extracción completa presentó una menor tasa de reintervención durante el seguimiento medio de 1,000 días comparado con los otros 2 grupos (6.7 vs. 57.7 y 43.8%, p < 0.01). La extracción parcial y la actitud conservadora mostraron una evolución parecida con una tasa de extracción completa final del 25% y del 37.5%. Se observó una incidencia de endocarditis del 8.4%; todos con antecedente de extracción parcial o actitud conservadora. Conclusiones: Las complicaciones de la bolsa, independientemente de la integridad de la piel, tratadas conservadoramente o con extracción parcial se asocian a alta tasa de reintervenciones, necesidad de extracción completa y evolución a endocarditis.

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Infecciones en el sistema de marcapasos. Extracción de electrodos. Estimulación permanente por vía femoral

Cited by 5 publications

References 35 publications

Use of the transfemoral access approach for cardiac stimulation device implantation when the superior venous approach is not feasible: A single-centre twenty-year series

Use of the transfemoral access approach for cardiac stimulation device implantation when the superior venous approach is not feasible: A single-centre twenty-year series

Transfemoral access when superior venous approach is not feasible equals overall success of permanent pacemaker implantation. Ten‐year series

Evolución de los pacientes con complicaciones locales en la bolsa del generador de un dispositivo implantable

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