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The shocking lung mass: a case report

S Mahajan1, J G Porterfield, L M Porterfield

  • 1Methodist Hospital, Memphis, Tennessee, USA.

Pacing and Clinical Electrophysiology : PACE
|September 1, 1996
PubMed
Summary
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A patient experienced hemoptysis due to an implanted cardioverter-defibrillator (ICD) patch eroding into the bronchus. Surgical removal of the ICD hardware and repair of the bronchus successfully resolved the complication.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Medical Device Complications

Background:

  • Implantable cardioverter-defibrillators (ICDs) with epicardial leads are used for arrhythmia management.
  • Epicardial lead placement involves routing leads on the surface of the heart.

Observation:

  • A patient presented with hemoptysis two years post-ICD implantation with epicardial patch leads.
  • Imaging revealed erosion of the posterior left ventricular patch into the lingular segmental bronchus.

Findings:

  • Surgical exploration (thoracotomy) confirmed the epicardial patch erosion into the bronchus.
  • The ICD hardware was successfully removed.
  • The eroded bronchus was surgically repaired.

Implications:

Related Experiment Videos

  • This case highlights a rare but serious complication of epicardial ICD lead placement.
  • Prompt diagnosis and surgical intervention are crucial for managing bronchopleural fistula secondary to device erosion.
  • Further research into lead design and implantation techniques may mitigate such risks.