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Pneumomediastinum and subcutaneous emphysema from pacemaker placement
1Division of Pulmonary and Critical Care Medicine, St. Louis University Health Sciences Center, 3635 Vista Ave. at Grand Blvd, PO Box 15250, St. Louis, MO 63110-0250, USA. espiritu@slu.edu
Pacing and Clinical Electrophysiology : PACE
|July 14, 2001
Summary
A rare complication of pacemaker insertion, extensive pneumomediastinum and subcutaneous emphysema, was successfully managed conservatively. This case highlights a non-surgical approach for managing air collection after transvenous pacemaker placement.
Area of Science:
- Cardiology
- Medical Devices
- Thoracic Surgery
Background:
- Percutaneous pacemaker lead insertion via the subclavian vein is an alternative to the cephalic vein approach.
- Complications, though rare, can occur during transvenous pacemaker procedures.
Observation:
- An 80-year-old male experienced extensive pneumomediastinum and subcutaneous emphysema post-pacemaker insertion.
- The patient did not present with a pneumothorax, a common associated finding.
Findings:
- Successful conservative management was achieved for the extensive air collection.
- This approach avoided surgical intervention for the reported complication.
Implications:
- Conservative management is a viable option for specific cases of pneumomediastinum and subcutaneous emphysema after pacemaker insertion.
- This case broadens the understanding of managing rare complications in cardiac device implantation.