title: Minimally invasive robotically assisted repair of atrial perforation from a pacemaker lead.
abstract: BACKGROUND
  We present the first reported case of robotic-assisted right atrial perforation repair and pacemaker lead extraction.
  
  
  METHODS
  A 75-year-old female with symptomatic sinus node dysfunction underwent atrial single chamber permanent pacemaker insertion via a persistent left superior vena cava approach. At one week follow-up a chest radiograph and a computerized dynamic tomography demonstrated that the right atrial lead had perforated the right atrial free wall. The patient remained asymptomatic without signs of pericardial tamponade, however urgent repair was warranted.
  
  
  RESULTS
  Utilizing the da Vinci robotic system (Intuitive Surgical Inc., Sunnyvale, California, USA), the pacer lead perforation was visualized, the lead retracted, and the right atrium repaired. The existing atrial lead was repositioned in the right atrial appendage.
  
  
  CONCLUSIONS
  The patient's postoperative convalescence was uneventful, and she was discharged home on the third post-operative day. This case demonstrates the increasing clinical utilization of robotic-assisted technology in minimally invasive cardiac surgery.
authors.affiliation: College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Hussain
authors.forename: Corey
authors.initials: C
authors.lastname: Adams
authors.forename: Alexis
authors.initials: A
authors.lastname: Mechulan
authors.forename: Peter
authors.initials: P
authors.lastname: Leong-Sit
authors.forename: Bob
authors.initials: B
authors.lastname: Kiaii
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D004724:Endoscopy / Q000379:methods; D004867:Equipment Design; D005260:Female; D006325:Heart Atria / Q000293:injuries* / Q000601:surgery*; D006335:Heart Injuries / Q000601:surgery*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013902:Radiography, Thoracic; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome