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Wei Y, Cai L, Wu X, Zhou G, Lu X, Peng S, Ding Y, Xu J, Chen S, Ouyang P, Liu S. Sub-pocket small-hole drainage for pocket hematoma after cardiac device implantation. Herz 2021; 47:63-66. [PMID: 33890136 DOI: 10.1007/s00059-021-05037-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/05/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
AIMS Pocket hematoma is a common complication associated with cardiac device implantation, but there are limited strategies to deal with this problem. We aimed to evaluate the effectiveness of sub-pocket small-hole drainage (SSD) as a new way to manage severe pocket hematoma. METHODS A total of 11 patients with severe pocket hematoma were selected for this case series study. The SSD procedure was performed and wound healing was monitored. RESULTS The SSD procedure was successfully performed on all 11 patients. The time window for SSD was 10-14 days (mean 12.0 ± 1.3 days) after cardiac device implantation. On average, 18.3 ± 2.3 ml of hematoma was drained , with a mean procedural time of 21.3 ± 2.6 min. The patients were followed up for 4-12 months and all pockets healed well, without any complications such as pocket infection, bleeding, device exposure, and electrode fracture. CONCLUSION Sub-pocket small-hole drainage is an alternative approach for dealing with severe pocket hematoma after cardiac device implantation.
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Affiliation(s)
- Yong Wei
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Lidong Cai
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Xiaoyu Wu
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Genqing Zhou
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Xiaofeng Lu
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Shi Peng
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Yu Ding
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Juan Xu
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Songwen Chen
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China
| | - Ping Ouyang
- Department of Cardiology, Shanghai Songjiang District Center Hospital, 201600, Shanghai, China
| | - Shaowen Liu
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No 100, Haining Road, 200080, Shanghai, China.
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Mehta NK, Doerr K, Skipper A, Rojas-Pena E, Dixon S, Haines DE. Current strategies to minimize postoperative hematoma formation in patients undergoing cardiac implantable electronic device implantation: A review. Heart Rhythm 2020; 18:641-650. [PMID: 33242669 DOI: 10.1016/j.hrthm.2020.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/04/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
Abstract
There are an increasing number of cardiac electronic device implants and generator changes with a longer patient life expectancy along with concomitant increase in antiplatelet and anticoagulant regimens, which can increase the incidence of pocket hematomas. We have conducted an in-depth analysis on the relevant literature, which is rife with varying definition of hematomas, on ways to reduce pocket hematomas. We have analyzed studies on periprocedural medication management, intraprocedural use of prohemostatic agents, and postprocedure role of compression devices.
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Affiliation(s)
- Nishaki Kiran Mehta
- Department of Cardiovascular Medicine, Beaumont Hospital Royal Oak, Royal Oak, Michigan; Oakland University William Beaumont School of Medicine, Rochester, Michigan; Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia.
| | - Kimberly Doerr
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Andrew Skipper
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Edward Rojas-Pena
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Simon Dixon
- Department of Cardiovascular Medicine, Beaumont Hospital Royal Oak, Royal Oak, Michigan; Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia
| | - David E Haines
- Department of Cardiovascular Medicine, Beaumont Hospital Royal Oak, Royal Oak, Michigan; Division of Cardiovascular Medicine, University of Virginia, Charlottesville, Virginia
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