title: Late Manifestation of Coronary Sinus and Left Atrial Perforation of a Left Ventricular Pacemaker Lead at Extraction.
abstract: A 56-year-old man presented for lead extraction of a left ventricular (LV) lead that had been deactivated due to hiccups and of a right ventricular (RV) lead with a high threshold. Pus was noted upon entering the pocket. The right atrial and RV leads were extracted, but traction on the LV lead caused ischemia and was not performed. An echocardiogram demonstrated the lead in the left atrium and a robotic-assisted thoracotomy was used to remove the lead that had unroofed the coronary sinus, gone into the left atrium, and perforated through the free wall into the pericardium.
authors: Department of Medicine and Surgery, University of Chicago, Chicago, Illinois.
authors: Adam
authors: A
authors: Oesterle
authors: Sections of Cardiology and Cardiothoracic Surgery and the Heart Rhythm Center, University of Chicago, Chicago, Illinois.
authors: Husam H
authors: HH
authors: Balkhy
authors: Department of Medicine and Surgery, University of Chicago, Chicago, Illinois.
authors: John
authors: J
authors: Green
authors: Department of Medicine and Surgery, University of Chicago, Chicago, Illinois.
authors: Martin C
authors: MC
authors: Burke
mesh_terms: D054326:Coronary Sinus / Q000293:injuries*; D020878:Device Removal / Q000009:adverse effects*; D006325:Heart Atria / Q000293:injuries*; D006335:Heart Injuries; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013997:Time Factors
keywords: coronary sinus perforation; late lead perforation; lead infection; lead related pericarditis; left atrial perforation; robotic cardiac surgery