Lead-dependent infective endocarditis with a large vegetation — is cardiosurgical treatment always necessary?

Boczar, Krzysztof, Ząbek, Andrzej, Dębski, Maciej ORCID: https://orcid.org/0000-0002-3669-3916, Musiał, Robert, Lelakowski, Jacek and Małecka, Barbara (2018) Lead-dependent infective endocarditis with a large vegetation — is cardiosurgical treatment always necessary? Folia Cardiologica, 13 (4). pp. 367-370. ISSN 2353-7760

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Abstract

A 31-year-old patient who had cardiac pacemaker (DDD) implanted at the age of 16 due to complete atrioventricular block was admitted because of suspicion of lead-dependent infective endocarditis (LDIE). Echocardiographic examination revealed a vegetation measuring 31 x 20 mm in connection with excessive loop of atrial lead and endocardium adjacent to tricuspid valve. The patient was qualified for hybrid procedure: surgical removal of the vegetation and transvenous extraction of intracardiac leads. Considering the stable condition of the patient, it was decided to postpone the procedure and intensive treatment with antibiotics and anticoagulation therapy with low molecular weight heparin was continued. Pharmacological treatment resulted in a reduction of vegetation dimensions to 25 x 15 mm, which allowed for changing the qualification of the procedure to transvenous lead extraction (TLE) of the DDD system. The procedure was carried out without complications. After normalization of inflammatory parameters and disappearance of the vegetation, a new stimulation system was implanted on the same side of the chest. During one-year follow-up, there was no recurrence of the infection.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 24 Jan 2023 17:30
Last Modified: 24 Jan 2023 17:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/90766
DOI: 10.5603/FC.2018.0079

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