title: Delayed presentation of totally avulsed right superior vena cava after extraction of permanent pacemaker lead.
abstract: Pacemaker lead extraction has been shown to be an effective and safe treatment for infected permanent pacemaker leads, however, they may lead to potentially serious complications, usually occurring during the extraction procedure. This report describes a case of a 48-year-old woman with a patent persistent left SVC and an infected permanent pacemaker lead of a DDD pacing system who underwent transvenous laser-assisted lead extraction using a combined SVC and femoral approach. Two days after the procedure the patient developed symptoms of SVC obstruction requiring surgical intervention. The right SVC was found to be almost completely destroyed with only a thin strip of the lateral wall intact and active bleeding. The probable causative mechanisms and surgical management are discussed.
authors.forename: Marzia
authors.initials: M
authors.lastname: Leacche
authors.forename: Yan
authors.initials: Y
authors.lastname: Katsnelson
authors.forename: Hassan
authors.initials: H
authors.lastname: Arshad
authors.forename: Tomislav
authors.initials: T
authors.lastname: Mihaljevic
authors.forename: James D
authors.initials: JD
authors.lastname: Rawn
authors.forename: Michael O
authors.initials: MO
authors.lastname: Sweeney
authors.forename: John G
authors.initials: JG
authors.lastname: Byrne
mesh_terms: D020878:Device Removal / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000628:therapy; D013479:Superior Vena Cava Syndrome / Q000209:etiology; D014683:Vena Cava, Superior / Q000293:injuries*; D020246:Venous Thrombosis / Q000209:etiology