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Septic paradoxical embolus through a patent foramen ovale after pacemaker implantation

D E Allie1, M D Lirtzman, C H Wyatt

  • 1Cardiovascular Institute of the South, Medical Center of Southwest Louisiana, Lafayette 70506, USA.

Insights

A septic paradoxical embolus from an infected pacemaker lead and patent foramen ovale (PFO) was treated. The successful intervention involved embolectomy, PFO closure, lead removal, and new pacemaker system implantation.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Devices

Background:

  • Pacemaker leads can be a source of infection, leading to complications like septic emboli.
  • Patent Foramen Ovale (PFO) is an atrial septal defect that can facilitate paradoxical embolism.

Observation:

  • A case of septic paradoxical embolus was identified.
  • The embolus originated from an infected pacemaker lead.
  • The patient had an associated patent foramen ovale (PFO).

Findings:

  • Successful intracardiac embolectomy was performed.
  • Pericardial patch closure effectively addressed the PFO.
  • Complete removal of the infected pacemaker lead and generator was achieved.
  • A new permanent epicardial lead pacemaker system was successfully implanted.

Implications:

  • This case highlights a rare but serious complication of pacemaker use.
  • Multimodal surgical intervention can effectively manage infected pacemaker leads and associated paradoxical emboli.
  • Prompt diagnosis and treatment are crucial for favorable patient outcomes.

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