Balanced general anesthesia in a patient with cardiac pacemaker extrusion
a case report
DOI:
https://doi.org/10.63162/v67n69e26635Keywords:
General anesthesia, Artificial pacemaker, Lead extraction, Echocardiography Transesophageal, Surgical wound infectionAbstract
Pacemaker (PM) generator extrusion is a rare complication, and may be associated with local infections, skin fragility, and local trauma. Treatment may involve simple surgical repair of the device site or, in more severe cases, removal of the entire system, requiring anesthetic support. This article reports the anesthetic management of a 79-year-old patient with complete PM extrusion after a fall from a standing position, followed by PM site infection, requiring surgical removal of the device. The patient underwent balanced general anesthesia with intraoperative transesophageal echocardiography monitoring, which revealed significant findings that changed the case’s outcome.
References
Sazzad, F., Ibrahim, F. B., & Khan, M. S. R. (2020). Skin Erosion and Exteriorisation of a Cardiac Implantable Electronic Device: Modified Surgical Approach. Journal of Bangladesh College of Physicians and Surgeons, 38(3), 155–157.
Yuksel S, Demir S, Sahin M. Total extrusion of a normally functioning pacemaker. Tex Heart Inst J. 2012;39(1):156-7.
Nichev J, Balabanski T. A case of total pacemaker extrusion. Europace. 2009 May;11(5):670.
Teixeira RA, Fagundes AA, Baggio Junior JM, Oliveira JC de, Medeiros P de TJ, Valdigem BP, et al. Diretriz Brasileira de Dispositivos Cardíacos Eletrônicos Implantáveis – 2023. Arq Bras Cardiol [Internet]. 2023;120(1):e20220892.
Yew KL, Steven A, Razali F. Pacemaker extrusion from innocuous direct impact to the chest wall. Heart Asia. 2013 Jun 21;5(1):100.
Gur DO, Gur O. Pacemaker extrusion: a rare clinical problem mainly in elderly adults. J Am Geriatr Soc. 2013 Oct;61(10):1844-5.
Jakobsen CJ, Berg H, Hindsholm KB, Faddy N, Sloth E. The influence of propofol versus sevoflurane anesthesia on outcome in 10,535 cardiac surgical procedures. J Cardiothorac Vasc Anesth. 2007 Oct;21(5):664-71.
Hussein AA, Wazni OM, Wilkoff BL. Cardiac Implantable Electronic Devices and Infective Endocarditis: A Call to Arms…. J Am Coll Cardiol. 2023 May 2;81(17):1726-1728.
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