Ventricular perforation by pacemaker lead repaired with two hemostatic devices

a b s t r a c t INTRODUCTION: Cardiac perforation is a rare, but potentially serious, complication of pacemaker implan- tation that may develop days or weeks after implantation. PRESENTATION OF CASE: In the current case, 92-year-old man underwent permanent pacemaker implanta- tion, but he presented 3 weeks later with severe symptoms. Computed tomography showed protrusion of the tip of the ventricular electrode through the right ventricle and into the chest wall. During an urgent surgical intervention, the lead was disconnected and extracted. A sealing hemostatic device and an hemostatic patch were applied to repair the ventricle; the procedure was uneventfull. DISCUSSION: This case demonstrates how the correct diagnosis of ventricular perforation is crucial, and should be followed immediately by surgical planning. CONCLUSION: The hemostatic patch is a valuable alternative to sutures in patients with thin and fragile ventricular wall, unable to undergo stitching.