Surgical management of superior vena cava syndrome following pacemaker lead infection: a case report and review of the literature

Journal of Cardiothoracic Surgery

Thanos Athanasiou¹  Meletis Kanakis²  Michail Vernandos²  Hutan Ashrafian¹  Leanne Harling¹  Dimitris Tassopoulos²  Umar AR Chaudhry¹  John Kokotsakis² 

[1] Department of Surgery and Cancer, Imperial College London, 10th Floor, QEQM Building, St Mary’s Hospital Campus, South Wharf Road, London W2 1NY, UK;Cardiac Surgery Department, Evangelismos General Hospital, Athens, Greece

关键词: Cardiopulmonary bypass;    Superior vena cava syndrome;    Pacemaker lead;   

Others  :  804466
DOI  :  10.1186/1749-8090-9-107

 received in 2014-02-23, accepted in 2014-06-13,  发布年份 2014

【 摘 要 】

Superior vena cava (SVC) syndrome is a known but rare complication of pacemaker lead implantation, accounting for approximately less than 0.5% of cases. Its pathophysiology is due to either infection or endothelial mechanical stress, causing inflammation and fibrosis leading to thrombosis, and therefore stenosis of the SVC. Due to the various risks including thrombo-embolic complications and the need to provide symptomatic relief, medical and surgical interventions are sought early. We present the case of a 48-year Caucasian male who presented with localised swelling and pain at the site of pacemaker implantation. Inflammatory markers were normal, but diagnostic imaging revealed three masses along the pacemaker lead passage. A surgical approach using cardiopulmonary bypass and circulatory arrest was used to remove the vegetations. Culture from the vegetations showed Staphylococcus epidermidis. The technique presented here allowed for safe and effective removal of both the thrombus and infected pacing leads, with excellent exposure and minimal post-procedure complications.

【 授权许可】

   
2014 Kokotsakis et al.; licensee BioMed Central Ltd.

【 图 表 】

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