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Enhancing Surgical Decision-Making for Infected Cardiac Device Lead Removal With 18F-FDG PET/CT: A Case Study and
Said Khallikane1, Reda Mounir2,3, Noureddine Atmani4,5
1Anesthesia-Intensive Medicine, Cardiothoracic Anesthesiologist Cardiothoracic Anesthesia-Cardiovascular ICU, Anesthesiology-ICU-Emergency Department Avicenna Military Hospital, Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakech Morocco.
Abstract:
Residual implantable cardiac electronic device (ICED) leads pose a significant infection risk, necessitating a multimodal diagnostic and therapeutic approach. This case highlights the critical role of PET/CT imaging in guiding surgical decision-making, particularly in cases of chronic infections with embedded or fractured lead fragments. While percutaneous extraction may be incomplete, surgical intervention under cardiopulmonary bypass is often required for definitive management. Early identification of residual infected material is essential to prevent recurrent sepsis and optimize patient outcomes. A comprehensive strategy integrating advanced imaging, targeted antimicrobial therapy, and surgical expertise is key to successfully managing complex ICED-related infections.
