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The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 649-654, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
R Brodman, R Frame, C Andrews and S Furman
Infection, although uncommon, can be the most lethal of all potential
complications after transvenous pacemaker implantation. The infection rate
at our institution has been 0.56% (42 implants) during the preceding 17
years for 7435 transvenous pacemakers implanted in 4333 patients. Four of
the 42 patients required use of cardiopulmonary bypass or inflow occlusion
to remove the infected transvenous leads. Seven patients had their
pacemakers implanted elsewhere and were transferred to our medical center
for treatment. One patient died postoperatively because of persistent
sepsis from a retained lead segment. All other patients survived, and none
had recurrent infection. We recommend removal of all hardware if there is
infection of the pacemaker system. If traction or other methods fail to
remove the transvenous portion of the pacemaker system, open methods of
removal, although rarely required, are safe and effective and should be
used without delay.
ARTICLES
Removal of infected transvenous leads requiring cardiopulmonary bypass or inflow occlusion
Department of Cardiothoracic Surgery, Montefiore Medical Center, Bronx, N.Y. 10467.
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