scholarly journals A rare case of pacemaker lead endocarditis successfully treated with open heart surgery

2019 ◽  
Vol 13 (11) ◽  
pp. 1068-1071
Author(s):  
Darko Boljevic ◽  
Aleksandra Barac ◽  
Petar Vukovic ◽  
Dejan Kojic ◽  
Milovan Bojic ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Late Onset ◽  
Open Heart Surgery ◽  
Clinical Signs ◽  
Blood Cultures ◽  
Pacemaker Lead ◽  
Open Heart ◽  
Average Delay ◽  
Advanced Medical Technology ◽  
Lead Endocarditis

Background: Cardiac device-related endocarditis has emerged as a serious complication in the era of advanced medical technology. Pacemaker related infections are rare and life-threatening with incidence from 0.06% to 7% and high mortality rate (30-35%). Diagnosis is hard, frequently delayed and could be even missed due to poor clinical findings. The average delay in diagnosis is 5.5 month. We report a case of the late-onset of pacemaker lead endocarditis caused by S. epidermidis successfully treated with open heart surgery. Case Report: Patient with persistent high fever for 11 month and suspicion for infective endocarditis was admitted in Cardiovascular Institute. No clinical signs of endocarditis were observed. TTE revealed large vegetation 30 × 17 mm attached to the atrial electrodes with high embolic potential. This finding was verified by transesophageal echocardiography (TEE), although CT scan did not reveal vegetation. Blood cultures were negative. A sternotomy with cardiopulmonary bypass was performed and electrodes were extracted with large vegetation. Intraoperative finding revealed large thrombus with vegetation around pacemaker leads. Cultures of the electrodes and vegetation revealed Staphylococcus epidermidis. Surgery was followed up with antibiotic treatment for 6 weeks. He has been followed up for the next 2 years, and without complications. Conclusion: The absence of criteria for endocarditis and negative blood cultures should not keep the physician from ruling out lead endocarditis. This complication carries high risk of mortality if left untreated.

Late Onset of Heart Block After Open Heart Surgery for Congenital Heart Disease

2007 ◽  
Vol 29 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Leonardo Liberman ◽  
Robert H. Pass ◽  
Allan J. Hordof ◽  
Henry M. Spotnitz
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Heart Block ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Late Onset ◽  
Open Heart Surgery ◽  
Open Heart

scholarly journals Pacemaker Dysfunction due to a Large Thrombus on Ventricular Lead

2019 ◽  
Vol 22 (2) ◽  
pp. E131-E133
Author(s):  
Zhen Xia ◽  
Jianhua Yu ◽  
Juxiang Li ◽  
Qinmei Xiong ◽  
Yanhua Tang ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Pacemaker Lead ◽  
Open Heart ◽  
Cardiac Events ◽  
Icd Implantation ◽  
Pacing Lead ◽  
Pacemaker Dysfunction ◽  
The Right

Background: Pacemaker lead–related thrombosis is a rare but severe complication in patients with pacing lead implantation in the right ventricle. We present a case with recurrent syncope after single-chamber implantable cardioverter defibrillator (ICD) implantation. Pacing lead–related thrombosis was observed during open-heart surgery. This induced intermittent pacemaker dysfunction and recurrent syncope. Case Presentation: A 67-year-old male patient presented with frequent episodes of syncope and a history of dilated cardiomyopathy and paroxysmal ventricular tachycardia. Normal coronary angiography was found, and therefore a single-chamber ICD was implanted into the right ventricle to prevent cardiac events in 2013. However, he was referred to our hospital because of recurrent syncope 3 to 4 years after ICD implantation. A comprehensive investigation was performed to find out the etiology for the recurrent syncope. Pacing lead thrombosis was finally observed during open-heart surgery, which can introduce intermittent pacemaker dysfunction. After the thrombus was removed and the lead was separated from the posterior leaflet of the tricuspid valve, the ICD functioned normally after reprogramming. Oral anticoagulant was prescribed after discharging. During the 1-year follow-up period, this patient was free of syncope. Conclusions: This case illustrated that pacemaker lead–associated thrombosis should be considered when the cardiac implantable electronic device fails to prevent patients from having cardiac events. Oral anticoagulant might be important for preventing thrombosis among patients with ICD implantation into the right ventricle.

scholarly journals An estimate for the source of coagulase-negative staphylococci in blood cultures

1987 ◽  
Vol 99 (2) ◽  
pp. 333-341 ◽  
Author(s):  
M. J. Haverkorn ◽  
M. J. Staal
Keyword(s):  
Blood Culture ◽  
Positive Blood Culture ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Culture Technique ◽  
Blood Cultures ◽  
The Other ◽  
Open Heart ◽  
Coagulase Negative Staphylococci ◽  
Two Populations

SUMMARYAn estimate for the source of coagulase-negative staphylococci in blood cultures is presented and its use illustrated in two populations. The method estimates the probability that a positive blood culture is positive due to contamination and the probability of it being positive due to bacteraemia. The effect of changes in efficiency of the blood culture technique on these estimates is demonstrated. One of the illustrative populations consists of 537 sample pairs from 273 patients, taken after open-heart surgery in 1978–80. The other consists of 500 consecutive sample pairs taken in one of two hospitals in 1983–4.

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

Blood Coagulation Studies and Extracorporeal Circulation in Man

1967 ◽  
Vol 18 (03/04) ◽  
pp. 634-646 ◽  
Author(s):  
N Thurnherr
Keyword(s):  
Blood Coagulation ◽  
Extracorporeal Circulation ◽  
Blood Clotting ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Fibrinolytic System ◽  
Open Heart ◽  
Clotting Factors ◽  
Blood Clotting Factors

SummaryBlood clotting investigations have been executed in 25 patients who have undergone open heart surgery with extracorporeal circulation. A description of alterations in the activity of blood clotting factors, the fibrinolytic system, prothrombin consumption and platelets during several phases of the operation is given.

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