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Removal of an Infected Permanent Pacemaker through a Right Atriotomy without Cardiopulmonary Bypass Via a Right Thoracotomy

체외순환 없이 우측 개흉술을 통한 우심방 절개 만으로 감염된 영구심박동기의 제거 치험

  • Choi, Kwang-Ho (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Yoon, Young-Chul (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Park, Kyung-Taek (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Yang-Haeng (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Hwang, Youn-Ho (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University) ;
  • Cho, Kwang-Hyun (Department of Thoracic and Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University)
  • 최광호 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 윤영철 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 박경택 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 이양행 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 황윤호 (인제대학교 의과대학 부산백병원 흉부외과학교실) ;
  • 조광현 (인제대학교 의과대학 부산백병원 흉부외과학교실)
  • Received : 2010.01.12
  • Accepted : 2010.03.23
  • Published : 2010.08.05

Abstract

A 52-year-old female presented with pain and swelling owing to recurrent inflammation on a generator pocket. She had undergone a permanent pacemaker implantation (DDD type) 7 years previously. We planned to insert a new pacemaker after removal of the previous generator and wires through a surgical approach. However, she had a history of the left modified radical mastectomy (MRM) with radiation therapy for breast cancer. For this patient, it would be difficult to care for the postoperative wound if we approached via the median sternotomy. Therefore, we decided to use a right atrial approach via a right thoracotomy. We removed the previous pacing wires through an atriotomy and inserted a new pacemaker using epicardial pacing leads without cardiopulmonary bypass.

References

  1. Sohail MR, Uslan DZ, Khan AH, et al. Management and outcome of permanent pacemaker and implantable cardiover- terdefibrillator infections. J Am Coll Cardiol 2007;49:1851-9. https://doi.org/10.1016/j.jacc.2007.01.072
  2. Bracke F, Meijer A, van Gelder LM. Lead extraction for device related infections: a single-centre experience. Europace 2004;6:243-7. https://doi.org/10.1016/j.eupc.2004.01.007
  3. Del Rio A, Anguera I, Miro JM, et al. Surgical treatment of pacemaker and defibrillator lead endocarditis. Chest 2003; 124:1451-9. https://doi.org/10.1378/chest.124.4.1451
  4. Chang JP, Chen MC, Guo G, Kao CL. Less-invasive surgical extraction of problematic or infected permanent transvenous pacemaker system. Ann Thorac Surg 2005;79:1250-4. https://doi.org/10.1016/j.athoracsur.2004.08.055
  5. Kim YS, Song H, Ryu YG, Jung SH. Pacing wire removal via a right atrlotomy: a patient with infected permanent pacemaker and who previously underwent CABG. Korean J Thorac Cardiovasc Surg 2009;42:256-8.