Utility of Surgical Direct Visualization in a High-Risk Patient of Bleeding During Extraction of Perforating Pacemaker Lead

Abstract

Nonsurgical transvenous removal of perforating leads after pacemaker implantation is relatively safe but can lead to fatal complications, i.e., cardiac tamponade. Therefore, conducting this procedure with surgical backup support has been recommended. On the other hand, invasive surgical extraction has the advantage of being able to safely repair the perforation site while checking damage to adjacent structures under direct visualization as compared with nonsurgical extraction. Therefore, surgical repair should be considered in patients at a high risk of bleeding and potential damage to adjacent structures by pericardial penetration. We illustrate a case in which development of cardiac tamponade was avoided successfully by surgical direct visualization in a high-risk patient of bleeding.