Coronary Artery Bypass Surgery after Lung Injury Due to a Displaced Atrial Pacemaker Lead

Introduction

Pacemakers and cardiac defibrillators are being implanted in rapidly increasing numbers. Due to the high quality of the material used such as the silicon coating of the leads and the possibility of excellent visualisation and control during the procedure, today transvenous permanent pacing can be achieved with low complication rates [[1]]. Severe complications are rare, but heart muscle perforations with concomitant significant pericardial effusions, some of them life-threatening, still do occur and require urgent intervention, such as an emergency puncture of the pericardium or a thoracotomy [[2], [3]]. Cardiac and lung perforation after pacemaker implantation is a rare complication [[2], [7]]. Generally, it can be managed by simple retraction of the lead; however, in symptomatic patients surgery may be required.

We report on an early perforation of the right atrium, pericardium and consecutively of the right lung with subsequent haemoptysis after dual chamber pacemaker implantation. As there was coexistent coronary artery disease, a primary open explantation of the lead and concomitant coronary bypass grafting was performed in the same operation.

References

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