Where do the Leads Lead? Severe Tricuspid Stenosis and Infection Secondary to Retained Leads-Juniper Publishers
JUNIPER PUBLISHERS - OPEN ACCESS JOURNAL OF CARDIOLOGY & CARDIOVASCULAR THERAPY Case Report A 58-year-old man was admitted to the hospital with asymptomatic hypertensive urgency. His medical history was significant for heart failure and complete heart block with a dual chamber pacemaker first implanted in 1985. Although he had more leads added over time, his previous leads were never removed. Examination revealed a left-sided generator and an old right-sided device with purulent eroded wires. He also had mild pedal edema. A chest radiograph ( Figure 1A ) demonstrated a complicated lead arrangement with wires connecting the generator on the left and the old generator pocket site on the right, an atrial lead (yellow arrow) in the correct position, and multiple ventricular leads (green and red arrows) passing through the tricuspid area (oval). Gated chest computed tomography showed a misplaced, abandoned lead piercing one of the tricuspid leaflets (Red arrow in Figur...