title: Surgical lead-preserving procedures for pacemaker pocket infection.
abstract: BACKGROUND
  In the treatment of pacemaker pocket infection, removal of the entire pacing system has been considered necessary to avoid recurrent infection. We report a series of patients treated surgically by our lead-preserving procedures.
  
  
  METHODS
  Between 1990 and 2001, a total of 18 patients underwent one of two types of lead-preserving procedures. Procedure 1 preserves the full length of the lead, and procedure 2 preserves only the distal part of the lead. Signs of bacteremia, endocarditis, or purulent material within the lead insulation preclude application of these procedures in patients with potential or definite pacemaker pocket infection.
  
  
  RESULTS
  Seventeen patients who met the indications for our procedures were discharged 7 to 14 days (8.9 +/- 2.4 days, mean +/- SD) postoperatively without signs of infection and were followed up for a total of 987 patient-months until the close of the study or death without recurrent infection. The remaining 1 patient, who did not meet the indications, suffered reinfection soon after the operation.
  
  
  CONCLUSIONS
  The follow-up data suggest that our lead-preserving procedures should be considered as alternatives to conventional removal of the entire pacing system in cases of pocket infection that meet specific criteria.
authors.affiliation: The First Department of Surgery, Showa University, Tokyo, Japan. dayama@med.showa-u.ac.jp
authors.forename: Makoto
authors.initials: M
authors.lastname: Yamada
authors.forename: Susumu
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shiojiri
authors.forename: Kazuto
authors.initials: K
authors.lastname: Maruta
authors.forename: Atsuyoshi
authors.initials: A
authors.lastname: Oki
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Iyano
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Takaba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000601:surgery*; D012086:Reoperation; D013203:Staphylococcal Infections / Q000601:surgery*; D013211:Staphylococcus aureus; D013212:Staphylococcus epidermidis