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Percutaneous management of atrium and lung perforation: A case report
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作者 Xu Zhou Feng Ze +1 位作者 Ding Li Xue-Bin Li 《World Journal of Clinical Cases》 SCIE 2019年第24期4327-4333,共7页
BACKGROUND Cardiac perforation by a transvenous lead is an uncommon but serious complication. Delayed perforation, defined as migration and perforation of an implanted lead at least 1 mo after implantation, is exceedi... BACKGROUND Cardiac perforation by a transvenous lead is an uncommon but serious complication. Delayed perforation, defined as migration and perforation of an implanted lead at least 1 mo after implantation, is exceedingly rare and prone to underdiagnosis, and its optimal management is currently unclear. We report an uneventful transvenous extraction of an active fixation lead that led to delayed perforation of the right atrium, pericardium, and lung, disclosed 2 mo after implantation.CASE SUMMARY A 61-year-old woman with atrial lead perforation was transferred to our center.She had a dual-chamber pacemaker with active fixation leads implanted 8 mo previously. At 2 mo after implantation, she complained of chest pain and hemoptysis. Chest computed tomography revealed atrial lead migration into the lung. No pericardial or pleural effusion was detected. She underwent transvenous lead extraction in the electrophysiology room with surgical backup.The percutaneous subxiphoid pericardial puncture was performed first, and a pigtail catheter was left in the pericardial sac throughout the procedure. Then, a new active fixation lead was implanted at a different site with less tension. After the active screw was retracted, the culprit atrial lead was explanted successfully with simple traction. There were no complications during or after the procedure.The patient recovered well and follow-up was uneventful.CONCLUSION Percutaneous management of perforated active fixation lead outside the pericardial sac under surgical backup is safe and effective. 展开更多
关键词 Lead perforation Transvenous lead extraction Percutaneous subxiphoid pericardial puncture Pacemaker lead Active fixation Case report
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