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[Perforation of the heart during implantation of a transvenous pacemaker. A report on two cases]
Insights
Right ventricular perforation during temporary pacemaker insertion occurred in two patients. Even without tamponade symptoms, pericardial blood necessitates monitoring for potential complications.
Area of Science:
- Cardiology
- Cardiac Surgery
- Critical Care Medicine
Background:
- Transvenous temporary pacemakers are crucial for managing bradyarrhythmias.
- Implantation carries inherent risks, including cardiac perforation.
Observation:
- Two patients experienced right ventricular wall perforation during transvenous temporary pacemaker implantation.
- Neither patient presented with overt symptoms of pericardial tamponade.
Findings:
- Despite asymptomatic presentation, thoracotomy revealed hemopericardium in both patients.
- Epicardial pacemakers were successfully implanted following thoracotomy.
Implications:
- Clinicians must maintain a high index of suspicion for pericardial tamponade in patients with temporary transvenous pacemakers.
- Anesthetizing patients with temporary transvenous pacemakers requires careful consideration of potential cardiac complications.
Abstract:
Perforation of the right ventricular wall occurred in 2 patients during implantation of a transvenous temporary pacemaker. Although neither of the patients showed any signs of symptoms of pericardial tamponade, blood was found in the pericardial sac at thoracotomy, by means of which epicardial pacemakers were inserted. The possibility of tamponade should therefore be kept in mind when anaesthetizing patients who received a temporary transvenous pacemaker.