scholarly journals Cardiac Perforation

2020 ◽  
Author(s):  
Keyword(s):  
Cardiac Perforation

Blood Provision for Cardiac Ablation (CA) Procedures in the Catheterization Laboratory; a Veteran Affairs Medical Center (VAMC) Experience in a Non-Trauma Center Setting

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S167-S168
Author(s):  
J M Petersen ◽  
V Patel ◽  
D Jhala
Keyword(s):  
Quality Assurance ◽  
Massive Transfusion ◽  
Medical Center ◽  
Case Series ◽  
Blood Bank ◽  
Cardiac Ablation ◽  
Cardiac Perforation ◽  
Catheterization Laboratory ◽  
Massive Transfusion Protocol ◽  
Transfusion Protocol

Abstract Introduction/Objective Cardiac perforation is a life-threatening complication (~1% risk, with reported rates between 0.2% to 5%) of CA procedures. As cardiac perforation may lead to extensive bleeding, it would be reasonable for a medical center carrying out CA to be capable of arranging for a massive transfusion protocol and for surgical repair as required. However, there is sparse literature to guide a non-trauma medical center implementing a CA program on what the number of red blood cell (RBC) units for crossmatch should be for each case. Methods In interdisciplinary collaborative meetings, the CA program logistics were agreed to between the multiple clinical services. Given the case series on the amount of drained blood in complicated cases, there was agreement that three units of RBCs would be crossmatched for each case. Education was provided on the massive transfusion protocol and on blood bank procedures. As part of quality assurance/quality improvement, records were reviewed from the beginning of the CA program (10/1/2019) to 1/31/2019 to determine number of patient cases, crossmatched units, and transfused units for quality assurance purposes. Results A total of fifteen patients underwent CA procedures, for which three units were crossmatched for each patient. As there were no cardiac perforations with the cardiac ablation procedures so far, no units were transfused. The organized approach for ensuring adequate blood bank support and education led to the reassurance, alleviation of clinical anxiety, and building of a successful CA program. Education sessions completed with thorough understanding of blood bank procedures including the massive transfusion protocol, labeling of blood bank specimens, and on ordering of blood for crossmatch. Conclusion This study provides a reference that may provide helpful guidance to other blood banks on what the number of RBCs to be crossmatched prior to each CA procedure. Multidisciplinary collaborative meetings in advance are an essential component for ensuring adequate support for CA procedures or any new service that requires blood product support. Thorough education of clinical staff on blood bank procedures particularly the massive transfusion protocol is also recommended. This procedure for massive transfusion should be available to be referred to in real time.

scholarly journals A Meta-analysis for Major Complications Between Traditional Pacemaker and Leadless Pacemaker

2019 ◽  
Author(s):  
Diyu Cui ◽  
Xiaorui Chen ◽  
Lin Wang ◽  
Yimeng Liao ◽  
Huan He ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Good Prospect ◽  
Vascular Events ◽  
Pacing Threshold ◽  
Cardiac Perforation ◽  
Leadless Pacemaker ◽  
Major Complications ◽  
Significant Difference

Abstract Objectives To compare the major complications between leadless pacemaker (LP) and traditional pacemakers(TP).Background The TP shows some advantages in avoiding pocket- and lead-related complications over the TP and is increasingly used in clinical practice. However, the clinical effect of LP remains controversial.Methods PUBMED、EMBASE、The COCHRANE LIBRARY、CNKI and WANGFANG databases were searched from July 2013 to August 2018. Data concerning the study’s design, patients’ characteristics and outcomes were extracted. The primary end-point is the major complications. The second end-points are elevated pacing threshold, cardiac perforation/effusion, device dislodgement and vascular events.Results A total of 6 studies fulfilled the inclusion criteria. Only 4 of which can provide the data of major complications. The main complications of LP were statistically significantly decreased compared with that of TP(OR 0.41,95%CI:0.29-0.56,P<0.00001,I2=42%).We extracted the data of elevated pacing threshold, cardiac perforation/effusion, device dislodgement and vascular events in 4 other of these 6 studies. There was no significant difference in elevated pacing threshold (OR 0.95, 95%CI:0.24-3.70,P=0.94, I2=31%), cardiac perforation/effusion(OR 1.78,95%CI:0.33-9.58, P=0.50,I2=87%), vascular events (OR1.58, 95%CI:0.45-5.53, P=0.47,I2=47%) and device dislodgement(OR 0.22,95%CI:0.01-5.69,P=0.36,I2=81%) between LP and TP.Conclusion Compared with TP, LP showed a significantly decreased risk in major complications. This indicates that LP has a good prospect to be applicated in clinical practice.

scholarly journals A Meta-analysis of Major Complications between Traditional Pacemakers and Leadless Pacemakers

2020 ◽  
Author(s):  
Yun-Qing Chen
Keyword(s):  
Pericardial Effusion ◽  
Risk Ratio ◽  
Clinical Effect ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Inclusion Criteria ◽  
Cardiac Perforation ◽  
Major Complications ◽  
Central Register ◽  
Reported Data

Objectives: We aim to compare the major complications between leadless pacemakers and traditional pacemakers.Background: Leadless pacemakers, which are increasingly used in clinical practice, have several advantages compared with traditional pacemakers in avoiding pocket- and lead-related complications. However, the clinical effect of leadless pacemakers remains controversial.Methods: PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the CNKI database, and the Wanfang database were searched from July 2013 to December 2019. Studies comparing leadless pacemakers and traditional pacemakers were included. The primary end point was major complications. The secondary end points were cardiac perforation/pericardial effusion, device revision or extraction, loss of device function, and death.Results: Six studies fulfilled the inclusion criteria. Only four of the six studies reported data on major complications.Leadless pacemakers were associated with a lower incidence of major complications (risk ratio 0.33, 95% confidenceinterval 0.25–0.44, P < 0.00001, I² = 49%). We extracted data on cardiac perforation/pericardial effusion, device revisionor extraction, loss of device function, and death from six studies. Our meta-analysis showed that leadless pacemakershave a higher risk of cardiac perforation or pericardial effusion (risk ratio 4.28, 95% confidence interval 1.66–11.08,P = 0.003, I² = 0%). No statistically significant differences were found for mortality, device revision or extraction, andloss of device function.Conclusion: Compared with traditional pacemakers, leadless pacemakers have a significantly decreased risk of majorcomplications, but have a higher risk of cardiac perforation or pericardial effusion.

scholarly journals Chest pain following permanent pacemaker insertion… a case of pneumopericardium due to atrial lead perforation

2018 ◽  
pp. bcr-2018-226318 ◽  
Author(s):  
Suleman Aktaa ◽  
Kavi Fatania ◽  
Claire Gains ◽  
Hazel White
Keyword(s):  
Chest Pain ◽  
Ct Scan ◽  
Permanent Pacemaker ◽  
Common Procedure ◽  
Cardiac Perforation ◽  
Lead Perforation ◽  
Repeat Chest ◽  
Normal Chest ◽  
Chest X Ray ◽  
Pacemaker Insertion

Permanent pacemaker (PPM) implantation is an increasingly common procedure with complication rate estimated between 3% and 6%. Cardiac perforation by pacemaker lead(s) is rare, but a previous study has shown that it is probably an underdiagnosed complication. We are presenting a case of a patient who presented 5 days after PPM insertion with new-onset pleuritic chest pain. She had a normal chest X-ray (CXR), and acceptable pacing checks. However, a CT scan of the chest showed pneumopericardium and pneumothorax secondary to atrial lead perforation. The pain only settled by replacing the atrial lead. A repeat chest CT scan a few months later showed complete resolution of the pneumopericardium and pneumothorax. We believe that cardiac perforation can be easily missed if associated with normal CXR and acceptable pacing parameters. Unexplained chest pain following PPM insertion might be the only clue for such complication, although it might not always be present.

Cardiac Perforation Complicated by Cardiac Tamponade and Sealed With Metallic Coils

2004 ◽  
Vol 57 (10) ◽  
pp. 990-992 ◽  
Author(s):  
Vicens Martí ◽  
Carlos Castaño ◽  
Pere Guiteras ◽  
Ermengol Vallés ◽  
José M. Domínguez de Rozas ◽  
...  
Keyword(s):  
Cardiac Tamponade ◽  
Cardiac Perforation ◽  
Metallic Coils

scholarly journals Minimal Cardiac Perforation by Lead Pacemaker Complicated with Pericardial Effusion and Impending Tamponade: Optimal Management with No Pericardiocentesis Driven by Echocardiography

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 191
Author(s):  
Carlo Caiati ◽  
Paolo Pollice ◽  
Luigi Truncellito ◽  
Mario Erminio Lepera ◽  
Stefano Favale
Keyword(s):  
Pericardial Effusion ◽  
Right Ventricular ◽  
Implantable Cardioverter Defibrillator ◽  
Optimal Management ◽  
Cardiac Perforation ◽  
Cardioverter Defibrillator ◽  
Active Fixation ◽  
Fixation Screw ◽  
The Right ◽  
Fluoroscopy Guidance

We report the case of a 51-year-old patient who underwent the implantation of a bi-ventricular implantable cardioverter defibrillator (ICD) complicated by a sub-acute right ventricular minimal perforation with pericardial effusion and echocardiographic signs of tamponade. A new echocardiographic plane orientation allowed us to diagnose this condition in emergency and to make the right decision without delay, which consisting in unscrewing the active fixation screw under fluoroscopy guidance, while the pericardiocentesis was postponed. Thanks to the intervention focused on eliminating the cause of the postcardiac injury syndrome, the patient recovered rapidly and ultimately avoided the pericardiocentesis procedure.

scholarly journals Diagnosis and management of iatrogenic cardiac perforation caused by pacemaker and defibrillator leads

EP Europace ◽  
2016 ◽  
pp. euw074 ◽  
Author(s):  
Christopher A. Rajkumar ◽  
Simon Claridge ◽  
Tom Jackson ◽  
Jonathan Behar ◽  
Jonathan Johnson ◽  
...  
Keyword(s):  
Cardiac Perforation ◽  
Diagnosis And Management

scholarly journals Asymptomatic Late Migration of an Atrial Pacemaker Lead into the Right Lung

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Nicolas De Schryver ◽  
Sebastien Marchandise ◽  
Geoffrey C. Colin ◽  
Benoît Ghaye ◽  
Jean-Benoît le Polain de Waroux
Keyword(s):  
Unusual Case ◽  
Pacemaker Lead ◽  
Cardiac Perforation ◽  
The Right ◽  
Manual Traction

This report illustrates an unusual case of asymptomatic late cardiac perforation by an atrial pacemaker lead into the right lung. In the present case, the lead was explanted by simple manual traction through the device pocket without any complications.

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