Uncomplicated prior right ventricular perforation due to a pacemaker lead - an incidental finding during coronary...

Area of Science:

• Cardiovascular Surgery
• Cardiac Electrophysiology
• Medical Device Complications

Background:

• Coronary artery bypass grafting (CABG) is a common surgical procedure for coronary heart disease.
• Pacemaker implantation is frequently performed in patients with cardiac rhythm disturbances.
• Pre-operative assessment aims to identify potential surgical risks and complications.

Observation:

• During CABG, right ventricular adhesion to the pericardium was noted after pericardiotomy.
• The adhesion was carefully dissected after initiating cardiopulmonary bypass (CPB).
• Evidence of prior perforation of the right ventricle by a pacemaker lead was discovered.

Findings:

• The adhesion was a consequence of a previous perforation by a pacemaker lead.
• This finding indicates a rare complication associated with long-term pacemaker use.
• The perforation site was successfully managed during the CABG procedure.

Implications:

• Highlights the importance of considering prior device interactions in cardiac surgery.
• Suggests potential need for imaging or assessment of pacemaker lead sites in specific surgical candidates.
• Underscores the complex interplay between cardiac devices and surgical interventions.