title: Video-assisted endoscopic removal of infected endocardial pacemaker lead with large floating vegetation.
abstract: The best management of pacemaker lead related endocarditis is complete surgical or percutaneous removal of the pacemaker system. Although the traditional surgical approach is via median sternotomy, we present two cases in which the lead and vegetations were removed using a video-assisted endoscopic technique through a limited right submammary incision. In each case the patient was supported by partial extracorporeal perfusion. Additional tricuspid valve repair and atrial septal defect closure was performed in one case. The postoperative courses were uneventful, illustrating that, when compared to the conventional open heart surgical approach, the less invasive approach can be a safe and effective way to remove an infected foreign body from the right heart with increased comfort, fast recovery, and a better cosmetic result.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
authors.forename: J J
authors.initials: JJ
authors.lastname: Chu
authors.forename: P J
authors.initials: PJ
authors.lastname: Lin
authors.forename: C H
authors.initials: CH
authors.lastname: Chang
authors.forename: C C
authors.initials: CC
authors.lastname: Wang
authors.forename: P P
authors.initials: PP
authors.lastname: Tan
mesh_terms: D000293:Adolescent; D000368:Aged; D020878:Device Removal; D004567:Electrodes, Implanted; D004697:Endocarditis, Bacterial / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D006327:Heart Block / Q000151:congenital / Q000628:therapy; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D016459:Prosthesis-Related Infections / Q000601:surgery*; D013290:Streptococcal Infections / Q000601:surgery*; D014741:Video Recording / Q000295:instrumentation*