Left ventricular free wall perforation by a right ventricular pacemaker lead: a case report
| Autor: | Kenji Enta, Masato Otsuka, Natsuko Satomi, Shigeharu Sawa, Ryota Asano, Yasuhiro Ishii |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Perforation (oil well) Lead perforation 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine law Case report medicine Fluoroscopy AcademicSubjects/MED00200 030212 general & internal medicine Dual Chamber Pacemaker Lead extraction medicine.diagnostic_test business.industry Surgery Pacemaker Catheter medicine.anatomical_structure Ventricle Left ventricular perforation Artificial cardiac pacemaker Transthoracic echocardiogram Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | European Heart Journal: Case Reports |
| ISSN: | 2514-2119 |
| Popis: | Background Lead perforation is one of the major complications of pacemaker implantation, but cases of right ventricular (RV) lead perforation through the septum and left ventricle are rarely reported. We described a rare case of left ventricular (LV) free wall perforation by an RV lead and the management of this complication. Case summary An 84-year-old man was admitted with a dual-chamber pacemaker due to pacing failure caused by an RV lead fracture. New lead implantation was performed on the next day, but pacing failure occurred again on the second post-operative day (POD). We found the lead perforation on the fluoroscopy during temporary pacemaker insertion. Computed tomography scan and transthoracic echocardiogram showed that the added lead perforated through both the septum and LV free wall. A new lead was inserted on the fourth POD, and an off-pump open chest surgery for extraction of the penetrating lead was performed uneventfully on the 20th POD. Discussion We considered that some features of the lead (SelectSecure 3830-69, Medtronic) may be related to this complication, as the lead was very thin, had a non-retractable bare screw and was inserted with a dedicated delivery catheter. We have to be careful when performing implantation of this kind of lead to avoid such a rare complication. |
| Databáze: | OpenAIRE |
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