A case report of total removal of infected pacemaker with cardiopulmonary bypass

A successful removal of infected pacemaker with septicemia, pre-DIC state, and pneumonia is reported. A 44-year-old man received transvenous permanent pacemaker implantation through right subclavian region at 42 years of age. Two years and 3 months after implantation an abscess formed around the generator. Since incision and drainage were not effective, the generator was removed after 2 months (another pacemaker was reimplanted at the opposite side), and the initial pacing lead was cut after 3 months of initiation of the infection. But wound healing was not obtained and high fever-up occurred. Arterial blood culture showed septicemia caused by Staphylococcus aureus. He also suffered pre-DIC state and pneumonia. The end of the cut lead had fallen into the right ventricle. After general condition was recovered, the residual lead and the reimplanted pacemaker system were extirpated under cardiopulmonary bypass. And at the same time a new pacemaker system was implanted again. He was in good postoperative course, and he is up and well 8 months after operation.