Right ventricular lead perforation through the septum, left ventricle, and pleura, managed by an open surgical approach

Figures

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  Figure 1. Postimplant chest radiograph showing septal right ventricular lead placement (A: posteroanterior view; B: lateral view) on day 0, and subsequent image on day 14 (C: posteroanterior view; D: lateral view) showing overt perforation with extension of lead into the left pleural space.

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  Figure 2. Computed tomography in sagittal section demonstrating ventricular lead (A), exiting the myocardium (B) with tip near the left lingula parenchyma (C).

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  Figure 3. A: Intraoperative image of ventricular lead exiting the left ventricle in close proximity to the left anterior descending artery and entering the left pleura. B: The pleura is opened and retracted with forceps, and the ventricular lead is seen abutting the lingula of the left lung.