A novel technique for removal of permanent pacemaker leads.
We removed from 4 patients pacemaker leads that had migrated or become infected. Case 1: A 62-year-old man developed uncontrollable infection of the pacing leads. Case 2: A 78-year-old man, whose infected pacemaker was removed, had a second one implanted in the contralateral side; the pacing lead infection from the first procedure, however, was uncontrollable. Case 3: A 56-year-old woman presented with dyspnea and hepatomegaly subsequent to the second implantation of a pacemaker; the pacing leads from the first procedure caused severe stenosis in both the superior and inferior vena cavae. Case 4: A 60-year-old woman had a ruptured and migrated pacing lead in the right ventricle. We operated using a cardiopulmonary bypass and a specially designed plastic tube for removal of the leads. Although Case 2 required reconstruction of the vena cavae, all patients recovered. When removal of pacing leads is necessary, it should be done as soon as possible with cardiopulmonary bypass.
Department of Cardiovascular-Thoracic Surgery, Saiseikai Suita Hospital, Osaka, Japan.
Yasuyuki
Y
Shimada
Masatoshi
M
Kawata
Yasushi
Y
Iwasaki
Hideyuki
H
Kawachi
Hitoshi
H
Yaku
Nobuo
N
Kitamura
D000368:Aged; D002315:Cardiopulmonary Bypass; D020878:Device Removal; D004567:Electrodes, Implanted / Q000009:adverse effects* / Q000382:microbiology; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial