Surgical management of superior vena cava syndrome following pacemaker lead infection: a case report and review of the literature
Author(s)
Type
Journal Article
Abstract
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.
Date Issued
2014-06-19
Date Acceptance
2014-06-13
Citation
Journal of Cardiothoracic Surgery, 2014, 9
ISSN
1749-8090
Publisher
BioMed Central
Journal / Book Title
Journal of Cardiothoracic Surgery
Volume
9
Copyright Statement
© Kokotsakis et al. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
CARDIAC & CARDIOVASCULAR SYSTEMS
Pacemaker lead
Superior vena cava syndrome
Cardiopulmonary bypass
TRANSVENOUS PACEMAKER
CARDIOPULMONARY BYPASS
INNOMINATE VEIN
IMPLANTATION
EXTRACTION
REMOVAL
THROMBOSIS
DEVICE
DEFIBRILLATOR
COMPLICATION
Device Removal
Echocardiography, Transesophageal
Follow-Up Studies
Humans
Male
Middle Aged
Pacemaker, Artificial
Sick Sinus Syndrome
Staphylococcal Infections
Staphylococcus epidermidis
Superior Vena Cava Syndrome
Surgical Wound Infection
Tomography, X-Ray Computed
Respiratory System
1103 Clinical Sciences
Publication Status
Published
Article Number
107