Surgical treatment of pacemaker-induced endocarditis [TRATTAMENTO CHIRURGICO DELLE INFEZIONI DA ELETTROCATETERE DI PACE-MAKER]

This report concerns a case of endocarditis related to transvenous pace-maker lead. Fever, positive emocultures and the visualization of vegetations along side of the electrode by transesophageal ecocardiography brought to the diagnosis. The infection, due to Staphylococcus epidermidis, was at the first time unresponsive to antibiotic therapy alone. The electrode was removed by cardiotomy with the use of extracorporeal circulation. During the procedure the tricuspid valve was repaired because of the posterior leaflet was partially destroyed by the infection. At the same time a new epicardial system was implanted. The post-operative course was uneventful and two months after discharge the patient has enjoyed good health and was free of infection recurrence. Clinical aspects and salient features of management of this complication are discussed.