[HSF] RV pacing lead perforation

[Tea Acuff]

Comment? Do we now have a relative indication that has a life of its own?

tea



----- Original Message ----
From: Prasanna Simha M <prasannasimha at gmail.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Sunday, March 16, 2008 1:11:10 AM
Subject: Re: [HSF] RV pacing lead perforation

Cardiologosts fprget that there will be adhesions so a perforation in
a late post op patient is usually asymptomatic. He could either have a
new lead into the RV or better still an LV lead viu the coronary
sinus.
Prasanna

On Sun, Mar 16, 2008 at 9:53 AM,  <markmarbey at aol.com> wrote:
> The patient is 72 years old. In 1995, he had an uneventful mitral valve repair. Two months ago, in the midst of a video-assisted lung biopsy, he had an episode of ventricular fibrillation. A pacer/defibrillator was implanted shortly thereafter. At his two month check-up, the RV lead failed to pace. Work-up shows the tip of the lead to have perforated the RV free wall nearest the apex. Surface echo shows a very small amount of fluid around the tip of the lead. The patient has no symptoms. The MV repair is intact. The only other patient issue is chronic renal failure with a creatinine in the low to mid 2's. The cardiologist is asking that I remove the lead and repair the RV perforation. I think the perforating lead should be left alone and the cardiologist should place a new RV lead. A review of the literature was not helpful. I did not find any comment about an otherwise asymptomatic pacing lead perforation.
>  Anyone care to comment? All opinions appreciated.
>  Mark Marbey
>
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-- 
Prasanna Simha M
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