心外膜リード感染に対して開胸抜去術と大網充塡を施行した1例

Infected Epicardial Pacemaker System Treated by Complete Removal of Pacemaker Leads and Omentopexy via Re-sternotomy：Report of a Case

はじめに　近年ペースメーカ（PM）感染の発生はまれであるが，感染した場合にはリードの処理が問題となる．われわれは心外膜へ植え込んだPM感染に対し，PM本体の摘出およびリード切断による一部摘除を行ったが，残存リードの感染が持続し，結果的にリードの全抜去を余儀なくされた1例を経験したので報告する．

A 66-year-old man was diagnosed with pacemaker pocket infection in the upper abdominal area. His generator was removed with partial resection of the epicardial leads, and a new device was reimplanted in his left prepectoral area. The abdominal wound was left open, and debridement was performed for several times. After the wound was cured, he complicated a chest pain and was diagnosed with residural epicardial pacemaker lead infection. He underwent complete removal of infected epicardial pacemaker leads and omentopexy under extracorporeal circulation via resternotomy. Postoperative course was uneventful. There was no sign of reinfection during the two-year follow-up.