Migration of a Temporary Epicardial Pacing Wire to the Main Pulmonary Artery Trunk During the Acute Phase After Cardiac Surgery (original) (raw)
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Temporary epicardial pacing wire removal: is it an innocuous procedure?
2010
The safety and efficacy of temporary pericardial pacing wires have been accepted and their use is common after cardiac operations. Complications related to pacing wire removal are unusual but it can be serious and even catastrophic. We report an unusual case of bleeding due the laceration and rent created in the saphenous vein graft wall by the metallic tip of the pacing wire at the time of pacing wire removal.
Hemorrhagic Shock After Epicardial Pacing Wire Removal: A Case Report
A & A case reports, 2017
Epicardial pacing wires are routinely used to avoid hemodynamic instability due to perioperative arrhythmias after cardiac surgery. In rare cases, pacing wires themselves can be associated with potentially life-threatening complications. Herein, we present a novel case of hemorrhagic shock and hemoperitoneum after temporary epicardial pacing wire removal.
Journal of Ayub Medical College, Abbottabad : JAMC
After Coronary Artery Bypass Graft (CABG) surgery, temporary epicardial pacing wires are placed on heart to meet unforeseen complications like bradyarrhythmias or asystoles. This step needs additional time, resources and has potential to cause complication. Even having less complications, is this additional step in elective CABG surgery necessary? Some important predictive factors in patients who require this pacing wire placement have to be isolated. The objective of the study was to avoid this step if not required especially in elective CABG surgery. This prospective observational study involved 1047 consecutive patients undergoing CABG at our institution from May 2006 to April 2008. Patient who did not receive pacing wire (230), Preoperative pacemaker (2), CABG with valvular surgery (10), CABG with Ischemic VSD or MR surgery (3), off-pump CABG (21), or incomplete follow-up (11) were excluded from the study. Patients who received pacing wire (770) were divided in two groups. Group...
Necessity of Temporary Epicardial Pacing Wires After Surgery for Congenital Heart Disease
The Annals of Thoracic Surgery, 2014
Temporary epicardial pacing wires are commonly placed in patients undergoing surgery for congenital heart disease. Though often helpful, these wires are not without risk. We aimed to identify characteristics that would obviate placement of temporary epicardial pacing wires in this patient population. A prospective observational study was performed on patients admitted to the pediatric intensive care unit after surgery for congenital heart disease between October 2011 and October 2012. Logistic regression analysis was performed to identify independent predictors of patients in whom wires were not helpful postoperatively. Wires were placed in 213 of 249 patients. Wires were helpful in 50 patients; 23 for diagnostic purposes only, 17 for therapeutic purposes only, and 10 for both. On logistic regression analysis, absence of intraoperative arrhythmias (p < 0.01), lower arteriovenous O2 difference (p < 0.01), and shorter duration of cardiopulmonary bypass (p = 0.050) were significant predictors of patients in whom wires were not helpful postoperatively. Further, the predicted probability based on logistic regression model using these 3 variables correctly identified 93% of patients who did not need pacing wires. Four complications (1.9%) related to wires occurred, including 1 episode of life-threatening bleeding that was found, during emergent exploration, to be due to atrial perforation at the wire insertion site. Temporary epicardial pacing wires are not necessary in many patients recovering from surgery for congenital heart disease. A conservative approach to their use may therefore be warranted.
Percutaneous Retrieval of a Pulmonary Artery Catheter Knot in Pacing Electrodes
CardioVascular and Interventional Radiology, 2007
To illustrate a successful approach to resolving a pulmonary artery catheter knot in the pacing leads of a cardiac resynchronization device. When planning invasive monitoring for patients having right chamber electrodes, fluoroscopic-guided catheter insertion and extraction is advisable. In the event of coiling or knotting, an interventional radiologist should be contacted as soon as possible to avoid serious complications.
Interactive cardiovascular and thoracic surgery, 2011
The use of temporary epicardial pacing wires during cardiac surgery is a routine procedure and has been associated with low morbidity. We describe a rare case of right paracardiac mass due to organized pericardial hematoma with right atrial compression around the epicardial pacing wires left in-situ, presenting three months following aortic valve replacement surgery. The case highlights the fact that such delayed complications can rarely occur around retained epicardial pacing wires following open heart surgery especially in patients on oral anticoagulants. The clinician should be alert to such an occurrence and during follow-up echocardiography always pay attention not only to the valve and ventricular function, but also to the pericardial and extra-pericardial space.
Legal medicine (Tokyo, Japan), 2018
Strangulation of the heart appears to be an exceedingly rare mechanical phenomenon that can develop with epicardial pacing wires in individuals undergoing somatic growth. Over the passage of time, owing to size mismatch between a fixed wire length and dynamically growing heart, the epicardial wire may embed around the heart resulting in the progressive over-pressurizing of involved cardiac structures. Depending on the location of the peak constriction pressures, cardiac strangulation may damagingly affect coronary circulation, heart valves function, or physiologic filling of the heart chambers, with risk of myocardial ischemia, decreased cardiac output, acute cardiac failure, ventricular arrhythmias and death. We report a case of a 29-year-old male with sudden cardiac death owing to cardiac strangulation with epicardial pacing wire that had been retained in place almost 30 years. At autopsy, an enlarged and abnormally contoured heart was found to be strangulated by an epicardial pac...