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Migration of an automatic implantable cardioverter-defibrillator patch causing massive hemothorax
R L Quigley1, M E Hamer, S Swiryn
1Department of Surgery, Northwestern University Medical School, Evanston Hospital, Illinois 60201, USA.
Texas Heart Institute Journal
|January 1, 1996
Summary
A migrated implantable cardioverter-defibrillator patch eroded into the lung, causing hemothorax. A hybrid system was used for replacement, minimizing surgery and protecting the patient.
Area of Science:
- Cardiology
- Medical Devices
- Surgical Complications
Background:
- The automatic implantable cardioverter-defibrillator (AICD) system includes shocking electrodes, sensing electrodes, and a generator.
- AICD systems are implanted in the abdominal wall to treat cardiac arrhythmias.
- Component migration is a known complication of AICD systems.
Observation:
- A patient experienced migration of an extrapericardially sutured shocking patch.
- The migrated patch eroded into the ipsilateral lung, causing a massive hemothorax.
- This complication necessitated an urgent thoracotomy for patch removal and hematoma evacuation.
Findings:
- The patient's migrated AICD patch eroded into the lung, leading to hemothorax.
- Surgical intervention was required to address the complication.
- A hybrid AICD system was implemented as a replacement solution.
Implications:
- This case highlights a rare but serious complication of AICD component migration.
- Prompt diagnosis and surgical management are crucial for patient outcomes.
- Hybrid AICD systems may offer a less invasive alternative for device replacement after complications.