title: Ventricular perforation by pacemaker lead repaired with two hemostatic devices.
abstract: BACKGROUND
  Cardiac perforation is a rare, but potentially serious, complication of pacemaker implantation that may develop days or weeks after implantation.
  
  
  METHODS
  In the current case, 92-year-old man underwent permanent pacemaker implantation, but he presented 3 weeks later with severe symptoms. Computed tomography showed protrusion of the tip of the ventricular electrode through the right ventricle and into the chest wall. During an urgent surgical intervention, the lead was disconnected and extracted. A sealing hemostatic device and an hemostatic patch were applied to repair the ventricle; the procedure was uneventfull.
  
  
  CONCLUSIONS
  This case demonstrates how the correct diagnosis of ventricular perforation is crucial, and should be followed immediately by surgical planning.
  
  
  CONCLUSIONS
  The hemostatic patch is a valuable alternative to sutures in patients with thin and fragile ventricular wall, unable to undergo stitching.
authors.affiliation: Cardiac Surgery Unit, University Hospital Campus Bio-Medico of Rome, Via Álvaro del Portillo, 21 - 00128 Roma, Italy. Electronic address: f.prestipino@unicampus.it.
authors.forename: Filippo
authors.initials: F
authors.lastname: Prestipino
authors.affiliation: Cardiac Surgery Unit, University Hospital Campus Bio-Medico of Rome, Via Álvaro del Portillo, 21 - 00128 Roma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nenna
authors.affiliation: Cardiac Surgery Unit, University Hospital Campus Bio-Medico of Rome, Via Álvaro del Portillo, 21 - 00128 Roma, Italy.
authors.forename: Adele
authors.initials: A
authors.lastname: Casacalenda
authors.affiliation: Cardiac Surgery Unit, University Hospital Campus Bio-Medico of Rome, Via Álvaro del Portillo, 21 - 00128 Roma, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Chello
keywords: Chest wall; Computed tomography; Hemothorax; Pacemaker; Surgery