Surgical Extraction of a Huge Pacemaker Lead Vegetation Causing Infective Endocarditis

Smazn Palash, M. D. Hossain, Tamjid Mohammad Najmus Sakib Khan, T. Meher, K. Hassan, Saiful Khan, N. Ahmed, Sohail Ahmed, Z. Haider
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Abstract

Infections of implantable intracardiac devices such as pacemakers are relatively rare but serious complications. In this paper we report removal of a huge vegetation in RV lead of permanent pacemaker though open surgical approach using extracorporeal circulation which was giving rise to lead endocarditis. A new epicardial lead was placed as the patient was pacemaker dependent. Though the culture of the extracted material didn’t reveal any organism but the patient was improved a lot after operation from both symptomatic (subsidence of fever) & hemodynamic point of view. In follow-up OPD visit she was found to be recovered well without any complication. In conclusion, explantation of the entire pacemaker system is necessary to cure lead endocarditis in addition to appropriate antibiotic therapy. (Cardiovasc. j. 2020; 12(2): 162-166)
巨大起搏器引线植物的手术摘除引起感染性心内膜炎
心脏内植入式装置如起搏器感染相对罕见,但并发症严重。在本文中,我们报告了通过体外循环开放手术方法去除永久性起搏器右心室导联中的巨大植被,这是引起铅心内膜炎的原因。由于患者依赖起搏器,因此放置了新的心外膜导联。虽然提取物的培养未发现任何生物,但从症状(退烧)和血流动力学的角度来看,术后患者有了很大的改善。在后续的OPD访问中,发现她恢复良好,没有任何并发症。综上所述,除了适当的抗生素治疗外,整个起搏器系统的外植是治疗铅性心内膜炎的必要条件。(Cardiovasc。j。2020;12 (2): 162 - 166)
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