[Left Internal Thoracic Artery Injury due to Lead Perforation After Pacemaker Implantation:Report of a Case]

Area of Science:

• Cardiology
• Medical Devices
• Surgical Complications

Background:

• Pacemaker lead perforation is a rare, life-threatening complication.
• While typically involving the heart, adjacent organ involvement is infrequent.
• Early detection and intervention are crucial for patient outcomes.

Purpose of the Study:

• To report a rare case of anterior mediastinal hematoma following pacemaker implantation.
• To highlight the diagnostic challenges and management of lead-induced hemorrhage.
• To emphasize the importance of considering lead perforation in postoperative hemodynamic instability.

Main Methods:

• Case report detailing a patient with sudden hypotension and shock post-pacemaker implantation.
• Computed tomography (CT) scan to identify the source of bleeding.
• Emergency surgical intervention for hemorrhage control.

Main Results:

• CT scan revealed an anterior mediastinal hematoma.
• Hemorrhage was attributed to the left internal thoracic artery, suspected to be caused by the pacemaker lead.
• Emergency surgery successfully managed the life-threatening hemorrhage.

Conclusions:

• Pacemaker lead perforation, though rare, can lead to severe hemorrhage involving adjacent structures.
• Prompt diagnosis via imaging and urgent surgical intervention are vital for survival.
• This case underscores the need for vigilance in identifying uncommon complications of pacemaker implantation.