Objective:To analyze and summarize the treatment strategy of acute cardiac perforation caused by pacing lead.Metheds:Retrospectively analyzed the clinical data of patients who underwent transvenous lead extraction(TLE)procedure in Peking University People's Hospital from January 2007 to January 2019.Results:The perforating leads of 25 patients with acute cardiac perforation were successfully removed,including 4 patients(16.0％)with pericardial effusion and 1 patient(4.0％)with peripheral organ injury whose perforating lead exited the right ventricular outflow tract and penetrated the left lung,resulting in left fluid pneumothorax.The hemodynamics of 25 patients were stable before procedure,with systolic blood pressure of(129.7±11.2)mmHg and diastolic blood pressure of(70.8±9.8)mmHg.The perforating leads of 24 patients(96.0％)were removed percutaneously,and 1 patient(4.0％)was removed via thoracotomy.Among the patients who underwent TLE procedure,22 leads(88.0％)were removed directly,and 2 leads(8.0％)were removed by locking stylet.1 patient developed pulmonary embolism after TLE procedure and recovered after anticoagulant therapy.Conclusions:For patients with acute cardiac perforation who are hemodynamically stable and without peripheral organ damage,TLE can be safe and effective treatment strategy.
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