Lead Ekstraksiyonu Sonrası Hemotoraks: Tanı ve Tedavi Yaklaşımı
Özet
Transvenöz lead ekstraksiyonu, majör komplikasyon ve mortalite riski taşıyan invaziv bir girişimdir. İşlem sırasında veya erken postoperatif dönemde gelişen hipotansiyon, farklı klinik antitelerin bir sonucu olabilir. Hemotoraks da işlem sonrası hipotansiyon ile prezente olabilen, nadir ancak yaşamı tehdit edebilen bir komplikasyondur ve tanısı dikkatli klinik değerlendirme gerektirir. Hemotoraks gelişen hastaların bir kısmı sıvı ve kan ürünü replasmanı ile konservatif olarak izlenebilirken, bazı olgularda toraks tüpü uygulaması ve seçilmiş hastalarda da cerrahi girişim gerekebilmektedir. Bu yazıda da transvenöz lead ekstraksiyonu sonrası gelişen hemotoraks olgusu sunulmuş, literatür eşliğinde klinik yönetimi tartışılmıştır.
Transvenous lead extraction is an invasive procedure associated with the risk of major complications and procedure-related mortality. Hypotension developing during the procedure or in the early postoperative period may result from various clinical conditions. Hemothorax is a rare but potentially life-threatening complication that may present with postprocedural hypotension and requires a high index of clinical suspicion for prompt diagnosis. While some patients can be managed conservatively with intravenous fluid resuscitation, blood product replacement, and close clinical monitoring, others may require tube thoracostomy, and selected cases may ultimately require surgical intervention. In this report, we present a case of hemothorax following transvenous lead extraction and discuss its clinical management in the context of the current literature.
Referanslar
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