Browse
Submit Data
Databases
API
Help

Dataset Information

25 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Repair of pacemaker lead-induced right ventricular perforation via a left mini-thoracotomy.

ABSTRACT: Cardiac perforation is a rare but serious and life-threatening complication of permanent pacemaker implantation, with an incidence of 0.1-6%. Surgery is usually performed through a median sternotomy; however, sternotomy-related morbidity remains a concern. Herein, we report a case of surgical repair performed via a left mini-thoracotomy for a right ventricular perforation caused by implantation of a permanent pacemaker lead in a 56-year-old woman. Through the left fifth intercostal space, the pacemaker lead was observed to have penetrated the left ventricular myocardium, reaching the pericardium. The lead had passed through the right ventricle and the inferior ventricular septum and protruded from the left ventricular myocardium. After pacemaker lead removal, a dark blow-out type hemorrhage occurred; hence, repair was performed using a pair of pledgeted Mattress sutures. In conclusion, left mini-thoracotomy provides an adequate surgical field and has less impact on hemodynamics when operating at the cardiac apex. .

SUBMITTER: Uemura H

PROVIDER: S-EPMC8642623 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Similar Datasets

Left ventricular free wall perforation by a right ventricular pacemaker lead: a case report.

Project description:BackgroundLead 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 summaryAn 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.DiscussionWe 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.

| S-EPMC8010338 | biostudies-literature

Massive Hemothorax Due to Perforation of the Left Ventricular Apex with the Right Ventricular Lead.

Project description: Not available

| S-EPMC9721179 | biostudies-literature

Defibrillator lead migration and delayed presentation of right ventricular perforation.

Project description: Not available

| S-EPMC9735390 | biostudies-literature

A Shocking Case of Pacemaker Lead Perforation

Project description:We report on a 66-year-old man who presented with presyncope, chest discomfort, and pectoralis muscle stimulation after pacemaker implantation. Imaging confirmed lead perforation through the myocardium and reaching the anterior chest wall. (Level of Difficulty: Intermediate.) Central Illustration

| S-EPMC9537078 | biostudies-literature

Delayed presentation of right ventricular lead perforation following defibrillator implantation: a case report.

Project description:BackgroundPerforation of a device lead through the myocardium is a recognized complication of cardiac device implantation. The associated morbidity and mortality are significant, even though it is a relatively rare complication. Therefore, it is vital for acute clinicians to be aware of the diagnosis and subsequent management of myocardial perforation.Case summaryWe present the case of a 48-year-old woman who presented to the emergency department 1 month following implantable cardioverter-defibrillator implantation with chest and shoulder pain. Initial assessment revealed bilateral pleural effusions and anaemia. Computerized tomography of her chest and abdomen demonstrated a pericardial effusion, but it was transthoracic echocardiography that confirmed the diagnosis of right ventricular perforation. Urgent system revision was undertaken.DiscussionThis case highlights the importance of clinical suspicion and the use of diagnostic echocardiography as an important diagnostic tool in symptomatic patient's post-cardiac device implantation.

| S-EPMC6764542 | biostudies-literature

Silent journey of a late lead pacemaker perforation.

Project description: Not available

| S-EPMC8105069 | biostudies-literature

Early and mid-term outcomes of minimally invasive mitral valve repair via right mini-thoracotomy: 5-year experience with 129 consecutive patients.

Project description:ObjectivesThis study analyzed the experience of a single institution with minimally invasive mitral valve repair (MIMVr) via a right mini-thoracotomy (RT), including short and mid-term morbidity and mortality as surgical outcomes, and rates of reoperation. Late follow-up findings regarding mitral regurgitation (MR) were also assessed.MethodsBetween January 2014 and January 2020, a total of 141 consecutive patients underwent MIMVr for mitral regurgitation at our institution via an RT, with late follow-up results (median 35 ± 15 months) available for 129 (91.4%). Findings regarding surgical approach, complications, reoperations, and late survival were examined. Late echocardiographic results showing recurrence of MR after mitral repair were also noted. Survival, freedom from reoperation, and recurrent MR (grade > 2) were evaluated by Kaplan-Meier analysis.ResultsMean age was 63.9 ± 14.3 years, mean ejection fraction was 66.9 ± 10.4%, and 2 patients (1.6%) underwent a reoperation. Concomitant procedures included atrial fibrillation ablation (18%), tricuspid valve surgery (16%). None (0%) experienced intraoperative conversion to sternotomy. A learning curve was observed as the number of cases increased. Overall in-hospital mortality and stroke incidence were both 0%. Freedom from recurrent MR (grade > 2) at 1, 3, and 5 years was 99.2, 94.9, and 94.9%, respectively, while freedom from reoperation at 1, 3, and 5 years after mitral valve repair was 98.4, 98.4, and 98.4%, respectively.ConclusionsEarly and mid-term results of MIMVr were satisfactory, with low rates of perioperative morbidity and recurrent MR, as well as reoperation and death. Furthermore, the protocols for patient selection and surgical approach were considered to be appropriate.

| S-EPMC8282559 | biostudies-literature

Late perforation of a passively fixated pacemaker lead through the right ventricle. A report and review of literature.

Project description:Lead perforation is one of the serious complications associated with cardiac pacemakers and implantable cardiac defibrillators. Late perforations - occurring more than one month after placement - are exceedingly rare and are usually more associated with actively fixed leads rather than passively fixed tined leads. We present a case of blunt ended tined lead perforation after 4 months of implantation managed by a two-step hybrid minimally invasive approach consisting of mini-thoracotomy and lead tip transection, followed by trans-venous lead extraction. <Learning objective: Late perforation of a pacemaker lead (occurring more than one month after placement) is an exceedingly rare complication and is usually more associated with actively fixed leads rather than passively fixed tined leads. We describe management of a blunt-ended tined lead perforation by a two-step hybrid minimally invasive approach consisting of mini-thoracotomy and lead tip transection, followed by trans-venous lead extraction.>.

| S-EPMC6149285 | biostudies-literature

Direct aortic TAVI via anterior right mini-thoracotomy using 32 mm myval for pure aortic regurgitation.

Project description:BackgroundAortic regurgitation with dilated annulus presents a technical challenge for conventional transcatheter aortic valve implantation (TAVI) procedures.Case presentationWe report a case of an 84-year-old frail patient with a history of breathlessness found to have severe aortic regurgitation and moderately impaired left ventricular systolic function. The patient underwent a successful TAVI procedure using the XL-Myval 32 mm transcatheter heart valve (THV) via an anterior right mini-thoracotomy with a direct aortic approach. The patient recovered well post-operatively with good hemodynamic resolution.ConclusionsThis first in human case highlights the efficacy and potential of applying innovative approaches, such as the new sizes of Myval THV and direct aortic access via anterior right mini thoracotomy, in addressing challenging anatomical variations in TAVI procedures with good outcome.

| S-EPMC11363664 | biostudies-literature

Ventricular tachycardia due to delayed septal perforation by a left bundle branch area pacing lead.

Project description: Not available

| S-EPMC10885722 | biostudies-literature