[Surgical therapy of intracardiac infected pacemaker electrodes and catheter remnants]. 1986

S Schüler, and R Hetzer, and T Stegmann, and H G Borst

With the increase of pacemaker and central venous catheter implantation the number of intracardiac infections now constitutes a significant problem. Twenty patients between 22 and 77 years of age admitted for intracardial infected pacemaker probes or central venous catheter remnants presented with recurring attacks of endocarditic fever; in one case multiple pulmonary abscesses resulted from septic embolization. Staphylococci were the most frequently involved organism (75%). Risk factors leading to intracardiac infection were local reoperations and diabetes mellitus. Removal of the foreign body was achieved by cardiotomy in all cases. Twelve patients were operated upon without the use of the heart-lung machine, but extracorporeal circulation was necessary in 8 patients. There was one fatality in each of the 2 techniques, for a total mortality rate of 10%. In all cases the foreign bodies were removed without intracardial damage and the endocarditis was cured. When attempts at external extraction fail, the foreign body should be removed by either open or closed cardiotomy. This limits the danger of injury to the heart and of embolization of septic or thrombotic material. The use of the heart-lung machine is especially indicated in the presence of widespread, firm adhesions, or large bacterial vegetations and thrombi.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
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
D010210 Papillary Muscles Conical muscular projections from the walls of the cardiac ventricles, attached to the cusps of the atrioventricular valves by the chordae tendineae. Muscle, Papillary,Muscles, Papillary,Papillary Muscle
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011512 Proteus Infections Infections with bacteria of the genus PROTEUS. Infections, Proteus,Infection, Proteus,Proteus Infection
D011552 Pseudomonas Infections Infections with bacteria of the genus PSEUDOMONAS. Infections, Pseudomonas,Pseudomonas aeruginosa Infection,Infection, Pseudomonas,Pseudomonas Infection,Pseudomonas aeruginosa Infections
D002408 Catheters, Indwelling Catheters designed to be left within an organ or passage for an extended period of time. Implantable Catheters,In-Dwelling Catheters,Catheter, In-Dwelling,Catheter, Indwelling,Catheters, In-Dwelling,In Dwelling Catheters,In-Dwelling Catheter,Indwelling Catheter,Indwelling Catheters
D004566 Electrodes Electric conductors through which electric currents enter or leave a medium, whether it be an electrolytic solution, solid, molten mass, gas, or vacuum. Anode,Anode Materials,Cathode,Cathode Materials,Anode Material,Anodes,Cathode Material,Cathodes,Electrode,Material, Anode,Material, Cathode
D004697 Endocarditis, Bacterial Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use. Bacterial Endocarditides,Bacterial Endocarditis,Endocarditides, Bacterial

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