Biomaterial Database

[Removal of infected pacemaker leads under extracorporeal circulation]. 2007

Katsuaki Magishi, and Y Izumi, and N Shimizu, and D Uchida

Department of Thoracic and Cardiovascular Surgery, Nayoro City General Hospital, Nayoro, Japan.

We report 3 cases of removal of infected pacemaker leads under extracorporeal circulation. The infections occurred 12, 29, and 58 months after the implantations. A skin ulcer was at first formed over the pacemaker; then the pacemaker itself became infected. The right atrium was incised, and the infected leads were pulled out. The ventricular leads adhered to the tricuspid valve, the chordae tendineae and the endocardia. A lead tip could easily be extirpated with sharp scissors. Two cases underwent implantation of myocardial electrodes; the new generators were implanted below the fascia of the rectus abdominis muscle. In the other case, a pacemaker was implanted transvenously because an appropriate epicardial pacing site could not be found. Case infected by methicillin-resistant Staphylococcus aureus (MRSA) died from mediastinitis a month after the operation. The others did not have a recrudescence of their infections. Removal of the leads under extracorporeal circulation is an invasive but sure procedure to extirpate.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D010138	Pacemaker, Artificial	A device designed to stimulate, by electric impulses, contraction of the heart muscles. It may be temporary (external) or permanent (internal or internal-external).	Cardiac Pacemaker, Artificial,Artificial Cardiac Pacemaker,Artificial Cardiac Pacemakers,Artificial Pacemaker,Artificial Pacemakers,Cardiac Pacemakers, Artificial,Pacemaker, Artificial Cardiac,Pacemakers, Artificial,Pacemakers, Artificial Cardiac
D004567	Electrodes, Implanted	Surgically placed electric conductors through which ELECTRIC STIMULATION is delivered to or electrical activity is recorded from a specific point inside the body.	Implantable Electrodes,Implantable Stimulation Electrodes,Implanted Electrodes,Implanted Stimulation Electrodes,Electrode, Implantable,Electrode, Implantable Stimulation,Electrode, Implanted,Electrode, Implanted Stimulation,Electrodes, Implantable,Electrodes, Implantable Stimulation,Electrodes, Implanted Stimulation,Implantable Electrode,Implantable Stimulation Electrode,Implanted Electrode,Implanted Stimulation Electrode,Stimulation Electrode, Implantable,Stimulation Electrode, Implanted,Stimulation Electrodes, Implantable,Stimulation Electrodes, Implanted
D005112	Extracorporeal Circulation	Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation.	Circulation, Extracorporeal,Circulations, Extracorporeal,Extracorporeal Circulations
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D013203	Staphylococcal Infections	Infections with bacteria of the genus STAPHYLOCOCCUS.	Infections, Staphylococcal,Staphylococcus aureus Infection,Staphylococcal Infection,Staphylococcus aureus Infections
D013211	Staphylococcus aureus	Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications.
D016106	Methicillin Resistance	Non-susceptibility of a microbe to the action of METHICILLIN, a semi-synthetic penicillin derivative.	Methicillin-Resistant,Methicillin Resistant,Resistance, Methicillin