Khallikane Said, Mehdi Nabil, Didi Mehdi, Kbiri Hicham, Qamouss Youssef
Anesthesiology and Critical Care, Military Hospital of Avicenne, Marrakech, MAR.
Anesthesiology and Critical Care, Faculty of Medicine and Pharmacy of Rabat, Rabat, MAR.
Cureus. 2025 Jan 8;17(1):e77148. doi: 10.7759/cureus.77148. eCollection 2025 Jan.
Infectious myocarditis (IM) and infective endocarditis (IE), sometimes associated with infection of the surrounding mediastinal tissue or embolic complications caused by residual implantable cardioverter defibrillator (ICD) lead material embedded in the ventricle, present a significant challenge for cardiac surgeons due to the difficulty of precisely locating the old intracardiac pacing lead remnants because of the heart's continuous movement. We present the case of successful two-stage elective sternotomy extraction of two residual defibrillator leads, one trapped in the left innominate vein, easily removed after veinotomy without cardiopulmonary bypass (CPB), and the other embedded intramyocardially in the inferior wall of the right ventricle, successfully removed under CPB after fluoroscopic guidance. The patient was discharged four weeks post-operation without complications. In our case, transesophageal echocardiography (TEE) was not performed due to the patient's history of esophageal achalasia.
感染性心肌炎（IM）和感染性心内膜炎（IE），有时与周围纵隔组织感染或因残留植入式心脏复律除颤器（ICD）导线材料嵌入心室引起的栓塞并发症相关，由于心脏持续运动导致难以精确定位旧的心内起搏导线残余物，给心脏外科医生带来了重大挑战。我们报告了一例成功进行两阶段选择性胸骨切开术取出两根残留除颤器导线的病例，一根被困在左无名静脉，在未进行体外循环（CPB）的情况下静脉切开术后轻松取出，另一根心肌内嵌入右心室下壁，在透视引导下CPB下成功取出。患者术后四周出院，无并发症。在我们的病例中，由于患者有食管失弛缓症病史，未进行经食管超声心动图（TEE）检查。
