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Christof Schmid
Dieter Hammel
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Ann Thorac Surg 1997;64:1707-1712
© 1997 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Cardiac Pacemaker Infection: Surgical Management With and Without Extracorporeal Circulation

Markus J. Wilhelm, MD, Christof Schmid, MD, Dieter Hammel, MD, Sebastian Kerber, MD, Heinz Michael Loick, MD, Mathias Herrmann, MD, Hans H. Scheld, MD

Departments of Cardiothoracic Surgery, Cardiology, and Anesthesiology, Institute of Medical Microbiology, University of Muenster, Muenster, Germany

Accepted for publication July 17, 1997.

Background. Pacemaker infections are rare, but serious complications of pacemaker therapy. The generator pocket, the pacing leads, or both may be involved.

Methods. We report on 12 patients with infected pacemaker systems. Four patients suffered from localized generator pocket infections, 6 had infected leads, and 2 patients had both. Pacemaker systems were completely removed in all patients. When the infection was limited to the generator pocket, the pacemaker system was removed at the original implantation site. Extracorporeal circulation was employed for the explantation of infected pacing leads.

Results. No complications occurred in patients with localized generator pocket infections. One patient with infected leads who was preoperatively already in a serious clinical condition died of septic shock in the early postoperative period; another patient died of pulmonary complications after tricuspid valve replacement 14 months after pacemaker explantation. No recurrent infections were observed.

Conclusions. Explantation of the complete pacemaker system has proved a reliable method to eradicate infection. Complications have been rare, except in patients in a critically ill state who undergo cardiopulmonary bypass.






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Copyright © 1997 by The Society of Thoracic Surgeons.