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Removal of Infected Pacemaker Leads with Deep Hypothermic Circulatory Arrest and Open Surgical Exploration of the Superior Vena Cava and Innominate Veins
Author(s) -
FELDBAUM* DAVID M.,
BRODMAN RICHARD F.,
FRAME ROSEMARY,
CAMACHO MARGARITA T.,
GROSS JAY,
FERRICK KEVIN
Publication year - 1999
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1999.tb06825.x
Subject(s) - medicine , cardiopulmonary bypass , circulatory system , superior vena cava , deep hypothermic circulatory arrest , vein , hypothermia , sepsis , lead (geology) , circulatory collapse , surgery , cardiology , anesthesia , cerebral perfusion pressure , cerebral blood flow , geomorphology , geology
Despite the use of transvenous methods for extraction of infected leads, failed attempts may result in retained lead fragments. Retained lead fragments may be a focus of continued infection leading to sepsis. We present two patients in which conversion from cardiopulmonary bypass to hypothermic circulatory arrest allowed direct visualization, using venotomies in the superior vena cava and innominate vein to achieve complete removal of retained pacemaker lead fragments. Use of venotomies in the extracardiac venous system is a technical addition to prior descriptions of lead extraction using deep hypothermia and circulatory arrest.