ICD lead extraction: Not a benign procedure. External chest compression: Not a benign manoeuvre
Federico Sertic1, Paolo Bosco1, Antonella Ferrara1
1Papworth Hospital, Cambridge, UK.
Insights
A patient undergoing implantable cardioverter-defibrillator lead extraction experienced rare, life-threatening complications including cardiac tamponade and superior vena cava tear. Management involved emergency sternotomy, cardiopulmonary bypass, and laparotomy for liver laceration.
Area of Science:
- Cardiology
- Cardiac Surgery
- Critical Care Medicine
Background:
- Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
- Lead and device extraction procedures carry inherent risks.
- Complications, though rare, can be severe and require immediate intervention.
Abstract:
This is the case of a 45-year-old man who was electively admitted to our hospital for revision and extraction of his faulty implantable cardioverter-defibrillator lead and box. The procedure was complicated by cardiac tamponade requiring pericardiocentisis (unsuccessful) and cardiopulmonary resuscitation. The patient was then rushed to theatre for emergency sternotomy and institution of cardiopulmonary bypass. A tear in the superior vena cava was identified and repaired. Unfortunately, the patient suffered of a liver laceration, due to chest compression, which required emergency laparotomy. The aim of this report is to highlight the combination and management of two rare life-threatening complications that occurred in a single case.
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