Migration of epicardial pacing wire to aorta:a rare complication after heart surgery

Authors: Stasev А.N., Tarasov R.S., Rutkovskaya N.V.

Company: Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation

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Type:  Case reports


DOI: https://doi.org/10.24022/1997-3187-2019-13-2-184-189

For citation: Stasev А.N., Tarasov R.S., Rutkovskaya N.V. Migration of epicardial pacing wire to aorta: a rare complication after heart surgery. Creative Cardiology. 2019; 13 (2): 184–9 (in Russ.). DOI: 10.24022/1997-3187-2019-13-2-184-189

Received / Accepted:  03.06.2019/07.06.2019

Keywords: pacing temporary electrode migration open heart surgery

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Abstract

Currently, the use of temporary pacing is a standard part of the protocol for performing cardiac surgery. The electrodes of temporary pacing, in the case of an uncomplicated postoperative period, can be removed for 4–7 postoperative days. However, in some cases, especially in later periods. Complete removal of all electrodes is not possible due to the increased risk of developing damage and bleeding from the right ventricle or atrium. In this case, maximum cutting of the electrodes at the skin level is possible, leaving fragments of the electrodes in the subcutaneous tissue. In most cases, the left electrodes do not cause any complications. However, there are reports of possible migration of electrode fragments throughout the patient's body. This article discusses the clinical case of migration of the epicardial electrode fragments of the temporary paicing into the ascending aorta with perforation of the aorta wall and soft tissues of the anterior chest wall 12 months after mitral valve replacement, without any complications. Considering the impossibility of performing an open operation, a non-standard electrode removal approach was used – endovascular extraction of the electrode fragment without the development of any complications after the procedure.

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About Authors

  • Аleksandr N. Stasev, Cand. Med. Sc., Researcher, ORCID
  • Roman S. Tarasov, Doctor Med. Sc., Head of Department, ORCID
  • Natal'ya V. Rutkovskaya, Doctor Med. Sc., Senior Researcher, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery