Case Report: Perioperative nursing management in a patient with dilated cardiomyopathy undergoing EV-ICD implantation

Vollständiger Abstract

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This study provides a comprehensive overview of the perioperative nursing management for a patient with dilated cardiomyopathy who underwent extravascular implantable cardioverter-defibrillator (EV-ICD) implantation. Key preoperative nursing interventions included the formation of a multidisciplinary team to assess surgical indications and the patient's overall condition, the enhancement of nutritional support, meticulous preoperative skin preparation, psychological support, thorough equipment inspection, and training for positional cooperation. During the intraoperative phase, rigorous aseptic techniques were employed; nurses collaborated precisely in fluoroscopic and patient positioning, maintained vigilance against mediastinal tissue injury, and adhered to standardized nursing protocols during defibrillation threshold testing. Postoperative nursing care prioritized the prevention and management of mediastinal infections, the prevention of lead displacement, and the management of inappropriate shocks. Intensive monitoring of vital signs and device functionality was conducted, supplemented by comprehensive health education throughout the process and long-term follow-up care. Following standardized treatment and comprehensive nursing care, the patient was transferred to a local hospital in stable condition 19 days post-surgery. A six-month follow-up indicated normal performance of the EV-ICD, with no complications related to the device or the procedure.