Temporary epicardial pacing wire removal: is it an innocuous procedure?

Area of Science:

• Cardiovascular Surgery
• Medical Device Complications
• Cardiac Electrophysiology

Background:

• Temporary pericardial pacing wires are routinely used post-cardiac operations for hemodynamic support.
• Their safety and efficacy are well-established, making them a common practice in cardiac surgery.
• Complications associated with pacing wire removal are infrequent but can be severe.

Observation:

• This report details an uncommon case involving pacing wire removal after cardiac surgery.
• The complication arose from the metallic tip of the pacing wire causing a laceration and rent in the saphenous vein graft wall.
• This specific injury mechanism during removal is highly unusual.

Findings:

• The metallic tip of a temporary pericardial pacing wire caused significant damage to a saphenous vein graft during removal.
• This laceration led to an unusual and serious bleeding event.
• The case highlights a previously undocumented risk associated with pacing wire removal.

Implications:

• Clinicians should be aware of the potential for rare but catastrophic complications during temporary pacing wire removal.
• This case may prompt a review of pacing wire removal techniques and device design.
• Further investigation into preventing such iatrogenic injuries in cardiac surgery is warranted.