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The return of a disappearing entity: Dressler's syndrome after transvenous pacemaker implantation.

ABSTRACT: A 76-year-old woman with idiopathic dilated cardiomyopathy and left bundle branch block was admitted for biventricular pacemaker implantation. The procedure was complicated by perforation of a coronary sinus tributary vein and ensuing pericardial effusion without tamponade. Three months later, she presented with fever, pleuritic chest pain and functional class worsening. Pericardial and pleural effusions were noted. Sterile blood and pleural fluid cultures and failure to respond to antibiotic therapy led to the hypothesis of a Dressler-like syndrome. The patient improved clinically with a short course of steroid therapy and was discharged on colchicine. A chest X-ray performed after 2 months showed a complete remission of pleural effusion.

SUBMITTER: Tralhao A

PROVIDER: S-EPMC3962969 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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The return of a disappearing entity: Dressler's syndrome after transvenous pacemaker implantation.

Tralhão António A Cavaco Diogo D Trabulo Marisa M Ferreira António M AM

BMJ case reports 20140320

A 76-year-old woman with idiopathic dilated cardiomyopathy and left bundle branch block was admitted for biventricular pacemaker implantation. The procedure was complicated by perforation of a coronary sinus tributary vein and ensuing pericardial effusion without tamponade. Three months later, she presented with fever, pleuritic chest pain and functional class worsening. Pericardial and pleural effusions were noted. Sterile blood and pleural fluid cultures and failure to respond to antibiotic th ...[more]

PMID: 24654249

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Project description:BackgroundFluoroscopic guidance is the traditional method for the implantation of transvenous temporary cardiac pacemakers (TVTPs). This study aimed to compare the time, effectiveness, and safety of real-time three-dimensional transesophageal echocardiography (3D TEE) with those of fluoroscopy in guiding TVTP implantation.MethodsThe records of patients who underwent transcatheter aortic valve implantation (TAVI) guided by real-time 3D TEE or fluoroscopy between July 1, 2016, and June 30, 2020, were retrospectively analyzed. TVTPs were implanted by anesthesiologists via the right internal jugular vein (IJV) in the real-time 3D TEE-guided group (3D TEE group), and by interventional cardiologists via the femoral vein in the fluoroscopy-guided group (fluoro group).ResultsA total of 143 patients (3D TEE-group n=79, and fluoro group n=64) were included. No statistical differences were observed in the baseline characteristics of the two groups. TVTPs were successfully implanted in all of the patients. The needle-to-pace time was significantly shorter in 3D TEE group than in fluoro group (5.2±2.9 vs. 8.5±4.6 min, P<0.001). Further, the incidence of access complications was significantly lower in 3D TEE group than in fluoro group (3.8% vs. 12.5%, P<0.05). One patient in fluoro group who suffered cardiac perforation underwent drainage via pericardiocentesis. No patients in either group died because of TVTP placement. The total complication rates were significantly lower in 3D TEE group than in fluoro group (19.0% vs. 39.1%, P<0.05). No statistically significant differences existed between groups in terms of pacing threshold, the incidence of permanent pacemaker insertion after surgery, the length of postoperative intensive care unit (ICU) stay, or the duration of postoperative hospitalization.ConclusionsReal-time 3D TEE-guided can be used to effectively, quickly, and safely guide TVTP implantation. The procedure can be performed by properly trained anesthesiologists. Therefore, real-time 3D TEE is a suitable option for guiding perioperative TVTP implantation in patients undergoing cardiac surgery.

Dataset Information

The return of a disappearing entity: Dressler's syndrome after transvenous pacemaker implantation.

Publications

The return of a disappearing entity: Dressler's syndrome after transvenous pacemaker implantation.

Similar Datasets

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