Right ventricular lead perforation through the septum, left ventricle, and pleura, managed by an open surgical approach Alexander Iribarne, MD, MS, Rajbir.

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Presentation transcript:

Right ventricular lead perforation through the septum, left ventricle, and pleura, managed by an open surgical approach Alexander Iribarne, MD, MS, Rajbir S. Sangha, MD, Ian C. Bostock, MD, MS, Eric S. Rothstein, MD, Jock N. McCullough, MD HeartRhythm Case Reports Volume 4, Issue 9, Pages 397-400 (September 2018) DOI: 10.1016/j.hrcr.2018.05.004 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 Postimplant chest radiograph showing septal right ventricular lead placement (A: posteroanterior view; B: lateral view) on day 0, and subsequent image on day 14 (C: posteroanterior view; D: lateral view) showing overt perforation with extension of lead into the left pleural space. HeartRhythm Case Reports 2018 4, 397-400DOI: (10.1016/j.hrcr.2018.05.004) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Computed tomography in sagittal section demonstrating ventricular lead (A), exiting the myocardium (B) with tip near the left lingula parenchyma (C). HeartRhythm Case Reports 2018 4, 397-400DOI: (10.1016/j.hrcr.2018.05.004) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 A: Intraoperative image of ventricular lead exiting the left ventricle in close proximity to the left anterior descending artery and entering the left pleura. B: The pleura is opened and retracted with forceps, and the ventricular lead is seen abutting the lingula of the left lung. HeartRhythm Case Reports 2018 4, 397-400DOI: (10.1016/j.hrcr.2018.05.004) Copyright © 2018 Heart Rhythm Society Terms and Conditions