Surgical management of infected permanent transvenous pacemaker systems: ten year experience

Details

Serval ID
serval:BIB_C82DE70454A9
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Surgical management of infected permanent transvenous pacemaker systems: ten year experience
Journal
Journal of Cardiac Surgery
Author(s)
Vogt  P. R., Sagdic  K., Lachat  M., Candinas  R., von Segesser  L. K., Turina  M. I.
ISSN
0886-0440
Publication state
Published
Issued date
06/1996
Peer-reviewed
Oui
Volume
11
Number
3
Pages
180-6
Notes
Case Reports
Journal Article --- Old month value: May-Jun
Abstract
BACKGROUND: Between January 1985 and June 1995, more than 1800 consecutive patients underwent implantation of a new permanent cardiac pacemaker at our institution. Thirty-six patients (0.02%) had 45 reinterventions for infected pacemaker systems. METHODS: in group A, 24 of 27 patients received simultaneous implantation of a new pacemaker. One had reimplantation of the same pacemaker in the same pocket, and two did not require reimplantation. The leads were retained in 19 (70%) of the patients. In group B, nine patients underwent cardiopulmonary bypass or "pursestring" surgery for removal of an infected pacemaker; a new epicardial pacemaker system was simultaneously implanted in seven patients. RESULTS: Identification of an infectious agent failed in 17 patients (47%), and Staphylococci were found in 15 patients (42%). The time from pacemaker implantation to onset of infection ranged from 1 month to 11 years (mean 31 months; median 19 months) and the time from onset of infection to surgical treatment from 1 month to 7 years (mean 7 months; median 2 months). The mean follow-up time is 74 months (range, 1 month to 10 years; median 5 years). There were 9 reoperations in 3 patients (16%) of group A for recurrent infection of their retained leads ultimately necessitating the use of open cardiac surgery. There was no early death; six patients died late due to unrelated causes. CONCLUSIONS: Complete removal of all pacemaker leads is recommended; open heart surgery with the use of cardiopulmonary bypass is indicated in selected cases and is effective and safe.
Keywords
Adolescent Adult Aged Aged, 80 and over Cardiopulmonary Bypass Child Female Follow-Up Studies Humans Infection/*etiology/*surgery Male Middle Aged Pacemaker, Artificial/*adverse effects Retrospective Studies Staphylococcal Infections/etiology/surgery Time Factors
Pubmed
Web of science
Create date
14/02/2008 14:17
Last modification date
20/08/2019 15:43
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