Procedural Risk and Long Term Outcome of Pacemaker System Removal by Using Cardio-Pulmonary Bypass

Objective: Some patients with pervenous pacemaker need to remove whole pacing system via median sternotomy by using cardio-pulmonary bypass (CPB) because of infection or system failure.We examined the procedural risk and long term outcome of removal of pacing system by using CPB. Methods: From August 1998 to April 2011, the removal of leads was performed in 8 patients (mean age 59 years, including 7 male and 1 female) via median sternotomy by using CPB under general anesthesia. The original diseases were 4 A-V block, 2 SSS, 1 AF and 1 Brugada syndrome. The reason for removal were eradicating infection in 6 cases and allergy in 1case, lead functional failure in 1 case. Positive culture results were observed in 5 cases of 6 infectious cases, including 2 MSSA, 1 MRSA, 1 CNS, and 1 MRSE. Results: The Mode of concomitant operation includes 2 mitral valvuloplasty, 1 CABG, and 2 tricuspid annulo-plasty and 7 putting of myocardial pacing lead. For the long term follow up, one case of infection recurrence was observed, then received exchanging of the infected system. We identified all of the 7cases that were followed up are alive. Conclusions: Complete removals of pacing system by using CPB were safe and have been successful with favorable long term results.