98%
921
2 minutes
20
A 78-year-old man underwent pacemaker implantation via the left internal jugular vein 36 years ago. After 30 years, a new device was implanted via the right subclavian vein and the old lead was cut and buried underneath the skin due to infection. This time, the patient presented with persistent lead infection of the left side. We chose open heart surgery to excise the old lead because of severe adhesion and surrounding calcification. The infected lead was completely removed using cardiopulmonary bypass without complication. Old pacemaker leads tend to develop adhesion and calcification within the innominate vein and superior vena cava, and therefore, it is often difficult to remove it with percutaneous technique. It was considered that open heart surgery was useful to excise a very old pacemaker lead.
Download full-text PDF |
Source |
---|
Struct Heart
September 2025
The Carl and Edyth Lindner Research Center at the Christ Hospital, Cincinnati, Ohio, USA.
Severe, untreated tricuspid regurgitation is associated with worse clinical outcomes. While isolated tricuspid valve (TV) surgery has been linked to poor long-term outcomes, transcatheter TV therapies, including edge-to-edge repair and transcatheter tricuspid valve replacement (TTVR), have emerged as effective alternatives and have been shown to improve outcomes, leading to their regulatory approval in the United States. Conduction system abnormalities are commonly seen among patients undergoing TTVR due to the close proximity of the atrioventricular node and the His bundle to the TV annulus.
View Article and Find Full Text PDFEur Heart J Case Rep
September 2025
GNH Klinikum Kassel, Center for Cardiac Care, Mönchebergstraße 41-45, Kassel 34125, Germany.
Background: Pacemaker implantation has become a routine procedure in contemporary cardiology. Several possible complications during and after the procedure have been described, with this article focusing on the rare complication and the prevention of left-sided lead placement after arterial puncture.
Case Summary: A 90-year-old female patient was admitted to our hospital due to recurrent transient ischaemic attacks following a dual-chamber pacemaker implantation six weeks earlier.
JACC Case Rep
September 2025
Department of Radiology, Saint Louis University School of Medicine, St Louis, Missouri, USA. Electronic address:
Background: Ventricular pseudoaneurysm formation due to longstanding lead erosion is rare, and standardized guidelines for diagnosis and management are limited.
Case Summary: We present a case of a right ventricular pseudoaneurysm noted on computed tomography after a patient with a pacemaker, originally placed in 2013, was admitted for respiratory failure. PolyJet three-dimensional printing was employed to assist in presurgical planning and evaluating the spatial anatomic relationship of the lead to the ventricular outpouching.
Cureus
August 2025
Clinical Cardiac Electrophysiology, University of Arkansas for Medical Sciences, Little Rock, USA.
Dislodgement of cardiac implantable electronic device (CIED) leads following implantation ideally should not be missed. However, more often than not, patients do not undergo post-operative imaging following these procedures due to a lack of evidence behind the role of imaging following uncomplicated pacemaker (PPM) implantation procedures, based on the most recent guidelines This is a case report of a dual-chamber pacemaker (DC-PPM) right ventricular (RV) lead that was found dislodged and coiled in the right ventricular outflow tract (RVOT) as an incidental finding via a routine transthoracic echocardiogram (TTE) study two years after implantation. We intend to shed light on the significance of timely detection of lead-related complications, as they can result in poor outcomes for patients.
View Article and Find Full Text PDFCureus
August 2025
Department of Perioperative Medicine, Bart's Heart Centre, Barts Health NHS Trust, London, GBR.
Patients with Fontan circulation are increasingly presenting for non-cardiac surgical procedures in adulthood, often involving complex anaesthetic management due to their unique physiology. We report the case of a 39-year-old Fontan patient who underwent elective thoracoscopic epicardial pacemaker lead revision under one-lung ventilation, requiring advanced hemodynamic monitoring, inotropic support, and pulmonary vasodilators. This case highlights the significant perioperative challenges in such patients and the need for a specialised, multidisciplinary team.
View Article and Find Full Text PDF