Successful removal of an infected pacemaker electrode by open heart surgery under extracorporeal circulation.
A 33-year-old male with sick sinus syndrome, who had received a pacemaker implant 18 years earlier, was complicated with a generator infection. Although the infected generator was removed, he was suffered from the recurrent local infection associated with a retained pacemaker lead. After a new pacemaker system implantation from the other side of the subclavian vein, we attempted to remove the lead utilizing a pacemaker removal kit. However, this intervention procedure was unsuccessful, because fibrous adhesions had developed around the lead, accompanied by calcification along its course. As a last resort, we opened the heart under extracorporeal circulation and removed the lead under direct vision. The post-operative course was uneventful. In order to remove a long-term implanted pacemaker lead, the direct surgical procedure with extracorporeal circulation is a favorable mean alternative to conventional intervention techniques.
Tayama
E
E
Department of Surgery, Kurume University School of Medicine, Japan. eiki@med.kurume-u.ac.jp
Arinaga
K
K
Oda
T
T
Tomoeda
H
H
Maruyama
H
H
Nishimi
M
M
Akashi
H
H
Kawara
T
T
Oryoji
A
A
Aoyagi
S
S
D000328:Adult; D001424:Bacterial Infections / Q000628:therapy*; D006348:Cardiac Surgical Procedures; D005112:Extracorporeal Circulation; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*