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Ventricular perforation by pacemaker lead repaired with two hemostatic devices.

Filippo Prestipino1, Antonio Nenna1, Adele Casacalenda1

  • 1Cardiac Surgery Unit, University Hospital Campus Bio-Medico of Rome, Via Álvaro del Portillo, 21 - 00128 Roma, Italy.

International Journal of Surgery Case Reports
|December 3, 2014
PubMed
Summary

Cardiac perforation from pacemaker leads is a serious complication. Prompt diagnosis and surgical repair, potentially using hemostatic patches for fragile ventricular walls, are crucial for patient outcomes.

Keywords:
Chest wallComputed tomographyHemothoraxPacemakerSurgery

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Device Complications

Background:

  • Cardiac perforation is a rare but serious complication following pacemaker implantation.
  • Symptoms may manifest days or weeks after the initial procedure.

Purpose of the Study:

  • To highlight the critical importance of timely diagnosis and surgical intervention in cases of cardiac perforation post-pacemaker implantation.
  • To present a case illustrating the management of ventricular perforation.

Main Methods:

  • A 92-year-old male presented with severe symptoms three weeks after permanent pacemaker implantation.
  • Computed tomography revealed ventricular electrode protrusion through the right ventricle into the chest wall.
  • Urgent surgical intervention involved lead extraction and ventricular repair with a hemostatic device and patch.

Main Results:

  • The surgical procedure for lead extraction and ventricular repair was uneventful.
  • The hemostatic patch provided effective repair for the thin and fragile ventricular wall.

Conclusions:

  • Early and accurate diagnosis of ventricular perforation is paramount.
  • Immediate surgical planning and intervention are necessary.
  • Hemostatic patches offer a valuable alternative to sutures for repairing thin or fragile ventricular walls.