title: Endocardial left ventricular pacing after accidental aortic wall perforation.
abstract: Inadvertent endocardial placement of a pacing lead in the left ventricle through the aortic valve is a rare complication with an unknown incidence because of inadequate reporting. Reported cases are usually the result of lead insertion via the subclavian artery. A possible but very unusual situation is endocardial lead insertion in the left ventricle after aortic arch perforation. We report the case of a 72-year-old woman in whom a screw-in pacing lead accidentally perforated the aortic arch and continued its way through the ascending aorta, aortic valve and left ventricle, after insertion through the left subclavian vein. We describe how this complication was diagnosed, the predisposing factors, the risks it carries and the ways in which devastating consequences have so far been avoided, as the patient refused any surgical intervention including lead removal.
authors.affiliation: Department of Cardiology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania. Electronic address: sosdean.raluca@umft.ro.
authors.forename: Raluca
authors.initials: R
authors.lastname: Şoşdean
authors.affiliation: Department of Cardiology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Enache
authors.affiliation: Cardiology Clinic, Institute of Cardiovascular Medicine, Timişoara, Romania.
authors.forename: Răzvan Ioan
authors.initials: RI
authors.lastname: Macarie
authors.affiliation: Department of Cardiology, "Victor Babeş" University of Medicine and Pharmacy, Timişoara, Romania.
authors.forename: Sorin
authors.initials: S
authors.lastname: Pescariu
mesh_terms: D000368:Aged; D001011:Aorta / Q000293:injuries*; D001013:Aorta, Thoracic; D001021:Aortic Valve; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects*
keywords: Aortic arch; Arco aórtico; Artificial cardiac pacemaker; Complication; Complicação; Left ventricular endocardial pacing; Pacemaker cardíaco artificial; Pacing endocárdico do ventrículo esquerdo; Perforation; Perfuração