[Extraction of a 36-year-old Pacemaker Lead Using Cardiopulmonary Bypass]

A 78-year-old man underwent pacemaker implantation via the left internal jugular vein 36 years ago. After 30 years, a new device was implanted via the right subclavian vein and the old lead was cut and buried underneath the skin due to infection. This time, the patient presented with persistent lead infection of the left side. We chose open heart surgery to excise the old lead because of severe adhesion and surrounding calcification. The infected lead was completely removed using cardiopulmonary bypass without complication. Old pacemaker leads tend to develop adhesion and calcification within the innominate vein and superior vena cava, and therefore, it is often difficult to remove it with percutaneous technique. It was considered that open heart surgery was useful to excise a very old pacemaker lead.