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A case of permanent pacemaker lead infection
Caterina Simon1, Fabio Capuano, Antonino Roscitano
1Department of Cardiac Surgery, Saint Andrea Hospital, University of Rome La Sapienza, Rome, Italy.
Nature Clinical Practice. Cardiovascular Medicine
|August 30, 2008
Summary
A Staphylococcus aureus infection led to pacemaker lead issues and tricuspid valve endocarditis in a 70-year-old man. Surgical removal of the pacemaker system and debridement of tricuspid tissue successfully treated the infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- A 70-year-old male with diabetes mellitus presented with fever of unknown origin and oliguria.
- He had a history of sick sinus syndrome treated with a DDD pacemaker one year prior.
- Blood cultures revealed Staphylococcus aureus infection.
Observation:
- Echocardiography identified severe tricuspid regurgitation and masses on both atrial and ventricular pacemaker leads.
- Transesophageal echocardiography revealed a vegetation on the tricuspid septal leaflet.
- Coronary angiography showed significant occlusions in the left anterior descending and right coronary arteries.
Findings:
- The patient was diagnosed with pacemaker lead infection and tricuspid valve endocarditis.
- Surgical intervention under cardiopulmonary bypass was performed.
- The pacemaker system was removed, and the tricuspid tissue underwent debridement.
Implications:
- This case highlights the serious complications of pacemaker lead infections, including endocarditis and coronary artery disease.
- Prompt diagnosis and surgical management are crucial for favorable outcomes.
- Multidisciplinary collaboration involving cardiology, infectious diseases, and cardiac surgery is essential for managing such complex cases.
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