Lead Perforation Into the Left Internal Mammary Artery Causing Circulatory Collapse After Pacemaker Insertion
Rajesh Kumar1, Jathinder Kumar1, Ihsan Ullah1
1Department of Cardiology, St James's Hospital, Dublin, Ireland.
JACC. Case Reports
|March 8, 2022
Summary
A rare complication during pacemaker implantation led to ventricular perforation and hemorrhage into the left internal mammary artery, causing circulatory collapse. This case highlights a life-threatening risk associated with cardiac device procedures.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Device Complications
Background:
- Pacemaker implantation is a common procedure for managing symptomatic bradycardia.
- Ventricular perforation is a known but infrequent complication of pacemaker lead placement.
- Hemorrhage into adjacent vascular structures can lead to severe hemodynamic compromise.
Purpose of the Study:
- To report a rare case of pacemaker lead perforation.
- To describe the subsequent hemorrhage into the left internal mammary artery.
- To emphasize the potential for life-threatening complications during pacemaker implantation.
Main Methods:
- A 66-year-old female patient underwent pacemaker implantation.
- The pacemaker lead inadvertently perforated the ventricle.
- The lead traversed into the left internal mammary artery, causing hemorrhage.
Main Results:
- The lead perforation resulted in slow hemorrhage into the left internal mammary artery.
- The patient experienced circulatory collapse and shock.
- This represents a rare and critical complication of pacemaker implantation.
Conclusions:
- Pacemaker lead perforation into the left internal mammary artery is a rare but potentially fatal complication.
- Prompt recognition and management are crucial for patients presenting with shock post-pacemaker insertion.
- This case underscores the importance of meticulous technique during cardiac device implantation.
