title: Migration of a retained temporary epicardial pacing wire into an abdominal aortic aneurysm.
abstract: A 69-year old male was referred to our hospital for the treatment of coronary artery disease. Preoperative computed tomography (CT) revealed an abdominal aortic aneurysm (AAA) and a giant tumour of the left kidney. He underwent off-pump coronary artery bypass grafting (OPCAB) prior to aneurysmectomy and nephrectomy. Temporary epicardial pacing wires (TEPWs) were placed on the right atrium and right ventricle. The bipolar ventricular wire was removed and the unipolar atrial wire was cut flush with the skin surface on postoperative day 5. CT 7 days after the OPCAB procedure revealed a retained TEPW sutured to the right atrial wall. One month later, the patient underwent a repair of the AAA and left nephrectomy. We found that a TEPW had migrated inside the AAA intraoperatively. The retained TEPW was thus no longer observed on postoperative CT. Migration of the atrial pacing wire through the aortic lumen was suspected, although the detailed mechanism is unknown. This is the first reported case of a migrated temporary pacing wire into the aorta under noninfectious conditions.
authors.affiliation: Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University, Kagoshima, Japan kousuke@m3.kufm.kagoshima-u.ac.jp.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Mukaihara
authors.affiliation: Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University, Kagoshima, Japan.
authors.forename: Goichi
authors.initials: G
authors.lastname: Yotsumoto
authors.affiliation: Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University, Kagoshima, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University, Kagoshima, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects* / Q000379:methods; D005548:Foreign-Body Migration / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed
keywords: Aorta; Migration; Temporary epicardial pacing wire