Summary:
Skin erosion and exteriorization of the commonest cardiac
implantable electronic device (CIED) is usually caused by
localized infection as a result of “pocket” infection. But,
there are other recognized factors including an advanced
age with thin, fragile skin with precarious subcutaneous
fat. So, exteriorisation of a generator, and/or a lead, is not
always associated with bacterial contamination followed by
antibiotic therapy and contra-lateral re-implantation strategy.
Hence, it does not always make the removal of the material
an obligation. Our notable findings in a rare case of such
exteriorization stimulate us to look for and implement a
modified surgical technique. This 93-year-old extremely aged
wonderfully co-operative, multi-morbid woman had multiple
episodes of skin erosion and fixation, re-fixation surgery till
the best result achieved. We present a new technique for
cardiac pacing allowing for full patient recovery via an
alternative surgical way of CIED relocation.
Key Words: Cardiac implantable electronic device, Permanent
Pacemaker, Exteriorization
(J Bangladesh Coll Phys Surg 2020; 38: 155-157)
DOI: https://doi.org/10.3329/jbcps.v38i3.47064