Bizarre case of migration of a retained epicardial pacing wire

Juchem, Gerd; Golczyk, Karl; Kopf, Carsten; Reichart, Bruno; Lamm, Peter

doi:10.1093/europace/eun269

Cited by 19 publications

(16 citation statements)

References 4 publications

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“…10 The neurointerventional and cardiac literature also includes several reports of foreign bodies, including epicardial pacing wires, catheter tips, and detachable balloons. 1,3,6,8,11 Given the size of foreign objects relative to vessel caliber, most objects embolize into the distal ICA and middle cerebral artery (MCA) branches. It is exceedingly rare for a foreign body to become lodged in the CCA because of the larger size of that artery.…”

Section: Discussionmentioning

confidence: 99%

Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair

Meyers¹,

Sorkin

Shakir

et al. 2014

JNS

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F oreign body embolization is an unfortunate event that can complicate endovascular procedures. Intraluminal foreign bodies in the cerebral circulation are primarily described in the trauma, neurointerventional, and cardiac literature, although their true prevalence and incidence are unknown. There are no treatment guidelines for foreign body removal, and management depends on surgeon preference, previously described cases, and patient characteristics. We describe an unusual case of a guidewire introducer from a previous cardiac procedure that embolized within the right common carotid artery (CCA), causing the patient to experience a transient ischemic attack (TIA), and was surgically removed via a carotid cutdown approach. Case ReportHistory and Examination. A 64-year-old man presented to our facility with transient left-sided weakness and slurred speech consistent with a TIA several months after he had undergone complex mitral valve repair. The previous operation involved placement of a left-sided internal jugular venous catheter and a femoral artery cutdown for placement of an endovascular balloon in the aorta for cardiopulmonary bypass during the procedure. Postoperatively, the patient was treated with warfarin for 3 months. At the time of our examination, his National Institutes of Health Stroke Scale (NIHSS) score was 0, with no leftsided hemiparesis.Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair Department of Neurosurgery, Buffalo General Medical Center and Gates Vascular Institute at Kaleida Health, Buffalo, New YorkWith the use of endovascular techniques and indwelling catheters, potential complications can include embolization of fragments or components of various systems. The authors describe the surgical retrieval of a guidewire introducer from the right common carotid artery (CCA). A 64-year-old man was found to have a foreign body within the right CCA on CT angiography after he had presented with a transient ischemic attack. He had undergone a complex mitral valve repair several months before presenting to the authors' facility. That procedure involved a femoral artery cutdown and the insertion of an endovascular aortic balloon for cardiac bypass. As in most endovascular procedures, guidewire introducers were probably used to facilitate the introduction of the guidewire into the system during the procedure. Although rare, iatrogenic embolization of the introducer probably occurred during use of the guidewire. The guidewire introducer was successfully retrieved without complication by using a standard carotid cutdown approach. It is extraordinarily unusual for an extracorporeal part of an implantable system to embolize to the carotid circulation. To the authors' knowledge, this is the only reported case of an embolized guidewire introducer and the use of a carotid exposure to retrieve an intraluminal foreign body. This case demonstrates that a carotid cutdown approach can be used successfully for the retrieval of intraluminal extr...

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Section: Discussionmentioning

confidence: 99%

Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair

Meyers¹,

Sorkin

Shakir

et al. 2014

JNS

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“…Bu komplikasyonlar GEPT çıkartılması sırasında oluşabilir. Pacemaker teli çıkartılan hastalarda sonrasında aritmi, hemoraji-hemotorax ve tamponad, atriyal ve ventriküler yırtılma, SVG (safen ven greft) hasarı, koroner anastomoz bozuklukları, tel artığı yer değiştirmesi gibi ciddi komplikasyonlar olabilir (1)(2)(3)(4)(5). Komplikasyonların riski antikoagüle hastalarda ve re-do kardiyak cerrahide daha da artmaktadır (13).…”

Section: Discussionunclassified

“…Son yıllardaki yayınlarda GEPT kullanı-mı, nadir de olsa hemoraji ve kardiyak tamponad, atriyal ve ventriküler yırtılma gibi komplikasyonların yanında, pacemaker telinin çıkartılması sırasında gelişebilecek aritmi, telin çıkartılması sırasında veya sonrasında oluşabi-lecek kanama, tel bütünlüğünün kaybı nedeni ile yabancı cisim oluşması ve artık telin göçü gibi komplikasyonlarla ilişkilendirilmektedir (1)(2)(3)(4)(5)(6)(7)(8)(9)(10).…”

Section: Introductionunclassified

Açık kalp cerrahisinde geçici epikardiyal pacemaker tellerinin kullanılmasının klinik önemi

Coşkun¹,

Büyükateş²,

Tomrukçu³

2015

GenelTipDer

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Amaç: Açık kalp cerrahisi sırasında ve sonrasında geçici epikardiyal pacemaker desteği gerekebilmektedir. Bu çalışmanın amacı; erişkin açık kalp cerrahisinde pacemaker gereksinimi oluşturabilecek faktörlerin tespiti ve kullanım endikasyonlarının sınırlandı-rılmasıdır. Gereç ve yöntem: Çalışmaya Mayıs 2002-Kasım 2013 tarihleri arasında kliniğimizde açık kalp cerrahisi yapılan ve geçici epikardiyal pacemaker teli yerleştirilen 736 hasta dahil edilmiştir. Hastalarımızın yaş, cinsiyet ve geçirilen operasyon şekline göre sınıflandırıldı. Uygulanan cerrahi operasyonlar izole koroner revaskülarizasyon yapılan 665 hasta, aort kapak replasmanı yapılan 23 hasta, mitral kapak replasmanı 21 hasta, aort ve mitral kapak replasmanı beraber yapılan 7 hasta, çıkan aort replasmanı 6 hasta, atriyal septal defekt tamiri 9 hasta ve kardiyak kitle 5 hasta şeklinde idi. Bulgular: Epikardiyal pacemaker teli yerleştirilen hastaların 714 (%97)'ünde pacemaker desteğine ihtiyaç olmamıştır. İntraoperatif ve postoperatif dönemde yalnızca 22 (%3)'ünde atrioventriküler tam blok nedeni ile pacemaker kullanılması gerekti. Bu hastaların 6 tanesi sağ koroner arter lezyonu olan çoklu koroner arter sebebi ile by-pass cerrahisi uygulanan hastalardı. 16 tanesi valvüler cerrahi geçiren ve pompa çıkışı atriyoventriküler tam blok oluşan hastalar idi. Geçici epikardiyal pacemaker kullanılıp aort kapak replasmanı yapılan yalnızca 2 hastada persistan komplet dal bloğu sebebi ile kalıcı pacemaker uygulandı. Erken postop dönemde geçici epikardiyal pacemaker gereksinimi için atriyoventriküler blok, sinüs bradikardisi, junctional ritim, postperfüzyon atriyal fibrilasyon, kardiyopulmoner by-passdan ayrılma esnasında pacemaker ihtiyacı ve mitral müdahale gerektiren cerrahiler risk faktörleri olarak bulunmuştur. Epikardiyal pacemaker tellerinin kullanımı ve çekilmesi sırasında hiçbir komplikasyon oluşmamıştır. Sonuç: Kalp cerrahisinde epikardiyal pacemaker tellerinin rutin kullanılması gerekli değildir ancak açık kalp cerrahisi geçiren tüm hastalarda hayat kurtarıcı olması nedeni ile geçici epikardiyal pace tellerinin yerleştirilmesini öneriyoruz. Anahtar sözcükler: Açık kalp cerrahisi, kalp pili, atriyoventriküler blok, aritmilerClinical significance of temporary epicardial pacemaker wires using in open heart surgery Objectives: Temporary epicardial pacemaker support may be required during and/or after open heart surgery. The aim of the current study was to define the factors that may require pacemaker insertion in adult open heart surgery and to limit its' indications. Material and methods: We had included 736 patients that underwent open heart surgery and received temporary epicardial pacemaker in our clinic between May 2002 and November 2013. All patients were categorized according to age, gender and type of surgery. Types of surgery were as follows: Isolated coronary revascularization (665 patients), aortic valve replacement (23 patients), mitral valve replacement (21 patients), aortic and mitral valve replacement (7 patients), ascending aorta replacement (6 ...

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“…Une ablation tardive, notamment aprè s le septiè me jour postopé ratoire, est associé e à un risque accru d'ablation impossible des é lectrodes é picardiques [20], né cessitant souvent de les couper à la peau. Si ce geste paraît anodin, il expose né anmoins au risque de migration des é lectrodes retenues, qui peut survenir même quelques anné es aprè s [21,22].…”

Section: Ablation Des E´lectrodes E´picardiques Temporairesunclassified

Entraînement électrosystolique épicardique temporaire post-chirurgie cardiaque : modalités pratiques

Lazarescu

Mertès

Longrois³

2013

Annales Françaises d'Anesthésie et de Réanimation

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Bizarre case of migration of a retained epicardial pacing wire

Cited by 19 publications

References 4 publications

Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair

Carotid cutdown for surgical retrieval of a guidewire introducer: an unusual complication after mitral valve repair

Açık kalp cerrahisinde geçici epikardiyal pacemaker tellerinin kullanılmasının klinik önemi

Entraînement électrosystolique épicardique temporaire post-chirurgie cardiaque : modalités pratiques

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