Key result
Open surgical repair of right ventricular and atrial ruptures, combined with tricuspid valve replacement, successfully managed a life-threatening cardiac perforation caused by pacemaker lead dislodgment.
Case Report (n=1)
No
Unprotected manipulation of a permanent pacemaker lead during extraction can cause life-threatening cardiac perforation and valve injury requiring immediate surgical intervention.
Supports individualized surgical approaches for rare pacemaker lead perforations; hypothesis-generating and leaves open optimal strategies.
: We report the case of a 63-year-old female patient who was urgently admitted from electrophysiology laboratory (EP Lab) to operating room (OR) with hemodynamic instability and hemothorax. The dual-chamber pacemaker had been implanted 15 years ago. After median sternotomy she was evaluated for perforations and raptures of cardiac chambers and status of right ventricle (RV) lead of permanent pacemaker (PPM) by the surgeon. Evaluations revealed that RV and right atrium (RA) have been ruptured and tricuspid valve has been damaged as a result of dislodgment of RV PPM lead secondary to manipulations in electrophysiology (EP) lab. This lead was withdrawn through SVC and ruptures were repaired and tricuspid valve was replaced. The epicardial pacemaker was placed by the surgeon. After surgery, the patient was transferred to ICU, after three days she was discharged to ward and after 5 days from surgery she was discharged from hospital in good condition.
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Rastravan et al. (2022) conducted a case report in Pacemaker lead dislodgment and cardiac perforation (n=1). Surgical repair and tricuspid valve replacement was evaluated on Patient survival and discharge. Open surgical repair of right ventricular and atrial ruptures, combined with tricuspid valve replacement, successfully managed a life-threatening cardiac perforation caused by pacemaker lead dislodgment.
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