The dilemma of transvenous cardiac rhythm devices in hemodialysis patients: time to consider the epicardial approach?
| Autor: | Loay Salman, Gustavo G. Lopera, Arif Asif, Roger G. Carrillo |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_specialty
Cardiac Catheterization Catheterization Central Venous Pacemaker Artificial Superior Vena Cava Syndrome Prosthesis-Related Infections Heart Diseases medicine.medical_treatment Cardiac resynchronization therapy Electric Countershock Constriction Pathologic Prosthesis Design Cardiac Resynchronization Therapy Tricuspid Valve Insufficiency Renal Dialysis Internal medicine medicine Humans Cardiac Resynchronization Therapy Devices Endocardium Cardiac catheterization Tricuspid valve business.industry Patient Selection Cardiac Pacing Artificial medicine.disease Surgery Defibrillators Implantable Stenosis medicine.anatomical_structure Nephrology Catheter-Related Infections Cardiology cardiovascular system Kidney Failure Chronic Hemodialysis business Pericardium |
| Zdroj: | Kidney International. 79(12):1267-1269 |
| ISSN: | 0085-2538 |
| DOI: | 10.1038/ki.2011.53 |
| Popis: | A great majority of cardiac rhythm devices (pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy) are placed percutaneously through the central veins, across the tricuspid valve, and inserted into the endocardium. Recent data have emphasized that central venous stenosis and infection associated with transvenous leads can be observed in hemodialysis patients dialyzing with an arteriovenous access or a tunneled hemodialysis catheter.1 The development of stenosis not only produces symptoms but can also have a direct impact, decreasing dialysis dose by restricting blood flow. Because the leads of a transvenous cardiac rhythm device are directly exposed to blood, they are vulnerable to contamination during episodes of bacteremia, often necessitating the removal of a life-supporting device.1 Finally, transvenous leads can injure the valve and produce severe tricuspid regurgitation.2 |
| Databáze: | OpenAIRE |
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