Percutaneous aspiration and removal of infected leadless pacemaker vegetation
Kylie E Adamek1, Nowrin Haque1, Jose R Martinez-Parachini1
1Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Introduction:
Leadless pacemakers represent an increasingly utilized alternative to traditional pacing methods in those with prior bacteremia or at high risk for infection. The acknowledged resistance to infection is illustrated by the exceedingly rare documentation of it.
Methods:
We present a case of methicillin-sensitive Staphylococcus aureus endocarditis with associated leadless pacemaker infection necessitating percutaneous aspiration of the device-associated vegetation followed by extraction of the leadless pacemaker.
Results:
Large vegetation associated with a leadless pacemaker was percutaneously aspirated with a vacuum-assisted aspiration device, followed by successful extraction of the leadless pacemaker.
Conclusion:
While leadless pacemakers are seldom involved in infective endocarditis, ultrasound evaluation in high-risk patients with an undetermined source is reasonable. Before extraction, it is practical to consider aspiration of large associated vegetations with a vacuum-assisted device.
Insights
Leadless pacemakers are rarely infected, but this case shows Staphylococcus aureus endocarditis. Treatment involved aspirating vegetation and extracting the infected leadless pacemaker.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Device Technology
Background:
- Leadless pacemakers offer an alternative to traditional pacing, especially for patients with infection risk.
- These devices are known for their resistance to infection, with documented cases being rare.
Observation:
- A case of methicillin-sensitive Staphylococcus aureus endocarditis involving a leadless pacemaker is presented.
- A large vegetation was found associated with the leadless pacemaker.
Findings:
- Percutaneous aspiration of the large vegetation using a vacuum-assisted device was performed.
- Successful extraction of the infected leadless pacemaker was achieved.
Implications:
- While rare, leadless pacemaker infection necessitates prompt diagnosis and management.
- Ultrasound may be valuable for detecting vegetations in high-risk patients with unexplained symptoms.
- Aspiration of large vegetations prior to extraction is a practical consideration.
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