Elective permanent exteriorization of cardiac pacemakers

: Three clinical cases are reported in which the authors decided for the permanent exteriorization of a cardiac pacemaker. The decision was based in that many previous surgical procedures had been performed and the possibilities of new approaches were exhausted or that the soft tissues were not in a satisfactory condition to support a new pacemaker. Considerations are made of the indications of this procedure, of the absence of previous reports in the literature, and the possibilities of long term follow-up morbidity. Emphasis is made in the necessity of thoroughly explaining the patients and their relatives of the risks involved, and not to overindicate the procedure if other possibilities have not been exhausted.