Open AccessAortic perforation due to cardiac resynchronisation therapy defibrillator lead placement: Case report and medicolegal considerations
Author(s) -
Grande Antonino M.,
Fiore Antonio,
Merlano Maurizio,
Buzzi Fabio,
Mazzola Alessandro
Publication year - 2015
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2015.05.002
Subject(s) - medicine , cardiology , perforation , intensive care medicine , mechanical engineering , engineering , punching
A 45‐year‐old woman with dilated cardiomyopathy was admitted for the upgrade of a previously implanted pacemaker. Echocardiography showed intraventricular dyssynchrony and a low ejection fraction (0.35). Treatment with a cardiac resynchronization therapy defibrillator (CRT‐D) was selected and the device was implanted. CRT‐D interrogation revealed proper function. Following procedure termination, the patient went into cardiac arrest and died despite resuscitation attempts. An autopsy revealed that the medial aspect of the right atrium was pierced by an active lead and that the aorta had a deep lesion, 2 mm in length, on its lateral aspect. We explain the probable pathogenesis of this patient's death.