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Intrathoracic surgery for retained endocardial electrodes.

A Järvinen, A Harjula, K Verkkala

The Thoracic and Cardiovascular Surgeon

|April 1, 1986

Summary

Intrathoracic surgery effectively removed infected or malfunctioning pacemaker endocardial electrodes in 12 patients. Radical treatment, including electrode removal, is recommended for pacemaker infections, even if complex surgery is needed.

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Area of Science:

Cardiology
Thoracic Surgery
Infectious Diseases

Background:

Pacemaker infections and lead malfunctions pose significant clinical challenges.
Endocardial electrodes can lead to serious complications like infection or device failure.

Purpose of the Study:

To evaluate the outcomes of intrathoracic surgery for retained endocardial electrodes.
To assess the necessity and efficacy of radical treatment for pacemaker-related complications.

Main Methods:

Retrospective analysis of 12 patients undergoing intrathoracic surgery for endocardial electrode issues.
Indications included Staphylococcus aureus/epidermidis infection (11 patients) and lead malfunction (1 patient).
Surgical approaches included emergency and elective procedures, with cardiopulmonary bypass utilized in 6 cases.

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Main Results:

Eleven patients had infections, and one had a malfunctioning lead requiring removal.
Two emergency surgeries were performed due to myocardial rupture/cardiac tamponade and ventricular arrhythmia.
One patient required mitral prosthesis replacement due to infection.

Conclusions:

Intrathoracic surgery is a viable option for managing complex pacemaker electrode complications.
Radical treatment, including complete electrode removal, is crucial for resolving pacemaker infections.
Consideration of intrathoracic surgery for electrode removal is warranted even in complex cases.