Thorac Cardiovasc Surg 2010; 58(7): 431-433
DOI: 10.1055/s-0030-1249803
Short Communications

© Georg Thieme Verlag KG Stuttgart · New York

Pacemaker-Associated Thrombotic Occlusion of the Inferior Vena Cava Causing Liver Failure

T. Schroeter1 , I. Dähnert2 , N. Doll3 , F. W. Mohr1 , M. A. Borger1
  • 1Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
  • 2Pediatric Cardiology, Heart Center, Leipzig, Germany
  • 3Cardiac Surgery, Sana Heart Center, Stuttgart, Germany
Further Information

Publication History

received October 14, 2009

Publication Date:
04 October 2010 (online)

Abstract

Pacemaker implantation using endocardial leads can give rise to thrombotic venous occlusion. We report the case of a 23-year-old male with transposition of the great arteries, who had previously undergone a Senning repair at the age of one year. A sick sinus syndrome required pacemaker implantation with subsequent multiple lead revisions. Following the implantation of the last lead, the patient developed complete occlusion of the inferior vena cava (IVC) with stenosis of the superior vena cava (SVC) with pacemaker leads in both lesions. Liver failure, ascites and esophageal varices developed. Thrombolytic treatment was ineffective; finally the patient was listed for liver transplantation. We explanted the lead embedding the thrombosis, together with some lead remnants. The stenosis of the SVC and the occlusion of the IVC were dilatated and stabilized with four stents. Over a follow-up period of 4 months, NYHA class improved from NYHA III to NYHA I–II, the hepatic function showed complete remission, and a liver transplantation was not necessary.

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Thomas Schroeter, MD

Cardiac Surgery
Heart Center Leipzig

Struempellstrasse 38

04155 Leipzig

Germany

Phone: +49 3 41 86 50

Fax: +49 34 18 65 14 52

Email: thomas-schroeter@gmx.de