Pacemaker endocarditis: approach for lead extraction in endocarditis with large vegetations

Area of Science:

• Cardiology
• Infectious Diseases
• Surgical Innovation

Background:

• Large vegetations on pacemaker leads complicate removal due to embolism risk.
• Pacemaker endocarditis presents significant clinical challenges.

Purpose of the Study:

• To describe a safe and effective technique for removing pacemaker leads with large vegetations.
• To report successful management of pacemaker endocarditis in patients with complex lead vegetations.

Main Methods:

• A combined approach using transvenous lead removal and sternotomy with cardiopulmonary bypass was employed.
• This technique facilitated complete removal of infected pacemaker wires.

Main Results:

• The combined procedure successfully and safely removed large vegetations from pacemaker leads.
• Pacemaker endocarditis was resolved in both patients.
• New transvenous pacemaker devices were successfully implanted post-explantation.

Conclusions:

• A combined transvenous lead removal and sternotomy with cardiopulmonary bypass is a viable strategy for managing pacemaker endocarditis with large vegetations.
• This approach ensures safe explantation, infection resolution, and successful reimplantation.