Migration of a retained temporary epicardial pacing wire into an abdominal aortic aneurysm

Area of Science:

• Cardiology
• Vascular Surgery
• Medical Device Complications

Background:

• A 69-year-old male with coronary artery disease, abdominal aortic aneurysm (AAA), and a giant left kidney tumor underwent staged surgical procedures.
• The patient initially had off-pump coronary artery bypass grafting (OPCAB) with temporary epicardial pacing wires (TEPWs) placed on the right atrium and right ventricle.

Observation:

• Postoperative computed tomography (CT) revealed a retained unipolar atrial TEPW sutured to the right atrial wall.
• One month later, during AAA repair and nephrectomy, the TEPW was found to have migrated intraoperatively into the abdominal aortic aneurysm.

Findings:

• This is the first reported case of a migrated temporary pacing wire into the aorta under noninfectious conditions.
• The precise mechanism of atrial pacing wire migration through the aortic lumen remains unknown.

Implications:

• This case underscores the potential for unexpected TEPW migration, even in non-infectious scenarios.
• Highlights the importance of thorough postoperative imaging and awareness of rare device-related complications in complex surgical patients.