Cardiac perforation of the right ventricle: A rare complication of pacemaker implantation. The importance of a collaborative vision of a multi-disciplinary treatment team

2014 ◽  
Vol 177 (2) ◽  
pp. 621-624 ◽  
Author(s):  
Fabrizio Ceresa ◽  
Giuseppe Mario Calvagna ◽  
Salvatore Patanè ◽  
Enrico Maria Di Maggio ◽  
Placido Romeo ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Rare Complication ◽  
Pacemaker Implantation ◽  
Treatment Team ◽  
Cardiac Perforation ◽  
The Right

scholarly journals Surgical Repair of Subacute Right Ventricular Perforation after Pacemaker Implantation

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Takeshi Oda ◽  
Takanori Kono ◽  
Keiichi Akaiwa ◽  
Yasushi Takahara ◽  
Chie Yasuoka ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Rare Complication ◽  
Pacemaker Implantation ◽  
Median Sternotomy ◽  
Axillary Vein ◽  
Pericardial Cavity ◽  
Temporary Pacing ◽  
Pacing Lead ◽  
The Right

We report an 84-year-old woman who presented with right ventricular perforation 4 days after pacemaker implantation for syncope due to sick sinus syndrome. Median sternotomy revealed no pericardial effusion, but the pacing lead had penetrated the right ventricle and pericardium. When the pleura was opened, the tip of the lead was seen in the visceral pleura. The lead was cut in the pericardial cavity and extracted from the left subclavian wound together with the generator. The right ventricular perforation was sutured and a temporary pacing lead was placed on the right ventricular wall intraoperatively. Ten days after the surgery, a new pacemaker lead was placed in the ventricular septum via the right axillary vein. Right ventricular perforation is a rare complication after pacemaker implantation. Typically, it occurs at the time of implantation or within 24 hours after implantation. In the present case, the perforation of the right ventricle which needed urgent surgery occurred 4 days after implanting the pacing lead at the right ventricular apex. Great care should have been taken not to overlook this life-threatening complication even more than 24 hours after pacemaker implantation.

scholarly journals P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Right Atrial ◽  
Cement Embolism ◽  
The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

Migration of chemoport catheter to the right ventricle: A catastrophic rare complication

2022 ◽  
Vol 16 (1) ◽  
pp. 124
Author(s):  
Bharat Paliwal ◽  
Neha Goyal ◽  
Manoj Kamal ◽  
Rakesh Kumar
Keyword(s):  
Right Ventricle ◽  
Rare Complication ◽  
The Right

scholarly journals Clinical case of asymptomatic perforation of right ventricle during permanent pacemaker implantation

2019 ◽  
Vol 23 (4) ◽  
pp. 91
Author(s):  
A. N. Verevetinov ◽  
E. S. Tarasyuk ◽  
I. E. Dorovskih ◽  
J. V. Vakhnenko ◽  
V. N. Nikitin ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Conflict Of Interest ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Pacemaker Implantation ◽  
Myocardial Damage ◽  
Left Hand ◽  
Heart Failure Progression ◽  
Life Threatening ◽  
The Right

<p>The present paper discusses one of the serious complications of electrocardiostimulator implantation: electrode perforation of the right ventricle wall, a condition that can occur in both the early and late postoperative periods. The latter occurs less frequently, and the patient may be asymptomatic; this results in an adverse effect on the patient’s quality of life and disease prognosis. Knowledge about the symptoms of late perforation and algorithms to examine patients suspected to have this complication contributes to timely surgical intervention as well as prevention of heart failure progression and fatal outcomes. This paper describes a clinical case of right ventricular perforation 1.5 years after electrocardiostimulator implantation, wherein, despite the absence of pronounced clinical symptoms, the patient was successfully diagnosed with pacemaker testing, Holter diagnostics, echocardiography and computed tomography of thoracic organs. Myocardial damage was accompanied by small left-hand bone-diaphragm hydrotorax and hydropericardium. The risk factors of perforation in the present case were low body weight and age. In the course of the surgical operation performed with the exact observance of the chosen technique, the integrity of the myocardium of the right ventricle and the function of the electrocardiostimulator were restored. Thus, the life-threatening consequences of the described complication were prevented.</p><p>Received 12 September 2019. Revised 20 December 2019. Accepted 23 December 2019.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

Late Dissection of a Contegra Conduit: A Rare Complication

2019 ◽  
Vol 10 (2) ◽  
pp. 239-241
Author(s):  
Christian Ortega-Loubon ◽  
Joaquín Fernández-Doblas ◽  
Joaquín Pérez-Andreu ◽  
Manuel Fernández-Molina ◽  
María Sol Siliato ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Congenital Heart ◽  
Heart Defects ◽  
Rare Complication ◽  
Right Heart Failure ◽  
Right Heart ◽  
Surgical Palliation ◽  
The Right

Surgical palliation of many types of congenital heart defects requires the use of a conduit between the right ventricle and the pulmonary artery. Dissections of these conduits are very infrequent. We report a case of a ten-year-old girl who developed acute right heart failure related to a Contegra conduit dissection. She underwent a new conduit replacement on an emergency basis.

scholarly journals 656 Cough, a rare and not well recognized symptom of lead perforation

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Francesca Parisi ◽  
Elisabetta Demurtas ◽  
Marta Allegra ◽  
Lorenzo Pistelli ◽  
Francesca Frecentese ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Right Ventricular ◽  
Rare Complication ◽  
Pacemaker Implantation ◽  
Productive Cough ◽  
Loop Recorder ◽  
Lead Perforation ◽  
Ventricular Lead ◽  
The Right ◽  
Contrast Ct

Abstract Aims Along with relevant progress in technology, pacemaker implantation is continuously improving its safety and efficacy in treating patients with bradyarrhythmias. Despite this, this procedure has several complications, including haematoma, pneumothorax, lead dislodgement, infection, lead perforation, and tamponade. Methods and results A 64-year-old woman underwent loop recorder implantation, after recurrent loss of consciousness, in order to assess arrhythmic causes of syncope. Two weeks later, an episode of paroxysmal complete AV block, conditioning a pause of 3 s, was recorded. Thus, the patient was scheduled for urgent dual-chamber pacemaker implantation. No complication apparently occurred during the procedure. An active fixation ventricular lead was positioned in right ventricular septal apex while passive fixation atrium lead in the right appendage. Soon after implantation the patient started to suffer by non-productive cough, clearly related to ventricular stimulation, either in DDD or in VVI pacing modality. During spontaneous ventricular activation (RBBB) no symptoms occurred. Transthoracic echocardiography, performed the day after implantation, revealed a small pericardial effusion (diastolic diameter &lt; 10 mm) along the apical segments, near the tip of the right ventricular lead. Suspicion of right ventricular lead perforation arised. The patient underwent urgent contrast chest CT confirming pericardial effusion, and showing an intramyocardium placement of the right ventricular apical lead. No active bleeding in pericardium was observed. Due to persistence of symptoms, we decided to perform right ventricular lead repositioning in right middle septum, with pericardiocentesis back-up promptly available. Post-procedure, palpitation, and cough abruptly disappeared. After 3 months follow-up, no significant symptoms were reported and pericardial effusion gradually disappeared. Conclusions We describe a singular case of cough, as atypical symptom immediately after pacemaker implantation. Pericardial effusion and contrast-CT showing intra-myocardial position of the tip guided our suspicion to a possible right ventricular lead microperforation. Although right ventricular lead parameters were completely normal this findings didn’t exclude RV perforation. The lead perforation is known as a rare complication of device implantation. Typical symptoms of RV lead perforation are chest pain and hypotension. The patient described in our case showed a haemodynamically stable pericardial effusion accompanied by non-productive cough, clearly time-related to RV stimulation. In literature, there is only another similar case report. The cough is a rare and not well recognized symptom of lead perforation. Early diagnosis of RV perforation allows to perform urgently and safely (pericardiocentesis back-up) lead replacement/repositioning. Echocardiography and contrast-CT could be useful in order to assess a possible pericardial effusion or intramyocardial/pericardial position of RV lead tip.

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