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Ann Thorac Surg 1977;24:352-354
© 1977 The Society of Thoracic Surgeons

Articles

Removal of Infected Epicardial Electrodes by Traction

F. Gosalbez, M.D.*, J.L. Cofiño, M.D., J.L. Naya, M.D., F.A. de Linera, M.D.

Servicio Cirugía Torácica, Hospital General de Asturias, Oviedo, Spain.

Accepted for publication March 9, 1977.

* Address reprint requests to Dr. Gosalbez, Departamento Cirugía Torácica, Hospital General de Asturias, Oviedo, Spain

Five patients who had infected cardiac pacemakers with epicardial electrodes have been managed by exteriorization of the pulse generator and placement of an endocardial unit. In each case the remaining electrode leads were detached from the myocardium and removed by simple traction, avoiding a surgical procedure.

In 4 patients, sets of cables had been sutured to the myocardium through an anterior thoracotomy, in some instances using Teflon pledgets as buttresses. In one of these procedures a pericostal suture had been used to secure the leads from the thoracic cavity against the ribs. The remaining patient had received a subxiphoid pacemaker also implanted with sutures.

This is a consecutive series, and we have had no failures so far. All pulse generator units were bipolar and located beneath either the pectoral or the rectus muscle. All of them were functioning properly when infection was diagnosed. This procedure constitutes an alternative method of management when more conservative techniques, such as closed irrigation and debridement, cannot be utilized.




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