Removal of infected transvenous electrodes associated with giant vegetations under cardiopulmonary bypass

: A 69-year-old man was admitted because of endocarditis with septicemia following recurrent fever of one year duration. The patient had underwent implantation of DDD pacemaker for complete A-V block 2 years ago. Preoperative echocardiogram demonstrated giant vegetations around the intraatrial and intraventricular electrodes, however no pathogenic organisms were detected by serial blood cultures. Total pacemaker system including infected endocardial electrodes were removed under cardiopulmonary bypass successfully, and new epicardial electrodes were implanted at the same time. The patient was recovered uneventfully.