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Chronic pocket infection – all leads should to be removed ? Sprawa trudna; podczas TLE nie jesteśmy pewni rozległości infekcji Promnice 2014
Andrzej Kutarski Lublin (a_kutatski@yahoo.com)
www.usuwanieelektrod.pl
Chronic pocket infection – all leads should to be removed ?
CASE (2) L system implantation with abandonement of infected lead
Old infected pocket region (L)
The new system implanted ÂŽ
Paterek Edward
L Probably - the „original sin” - the new system impantation with abandonement of infected lead
Old infected pocket region (L)
The new system implanted ®
Paterek Edward
Probably - the „original sin” sin - the new system
impantation with abandonement of infected lead The new system implanted recently (R)
The old infected abandoned lead (1996) (L)
The „second one deadly sin”- only infected lead extraction – recently implanded DDD system was left – for what and why ?
www.usuwanieelektrod.pl a_kutarski@yahoo.com
JANUARY ...
Final diagnosis – LRIE but patient still have the pacing system TTE &TEE: NAD (no wegetations)
Positive swab culture ...
JANUARY / FEBRUARY...
First hospitalisation: LRIE
MARCH ...
The second hospitalisation: pneumonia, LRIE ?
The „third one deadly sin”- conservative treatment of LRIE if PM system is still present
www.usuwanieelektrod.pl a_kutarski@yahoo.com
APRIL ... Third hospitalisation: LRIE, conservative treatment
The „third one deadly sin”- conservative treatment of LRIE if PM system is still present MAY ... Fourth hospitalisation: LRIE, conservative treatment
Fifth hospitalisation: LRIE, S.O.S !!! JUNE ...
JUNE ...
TTE &TEE: wegetations !!!!!!!! www.usuwanieelektrod.pl a_kutarski@yahoo.com
JUNE ...
L
R
?
JUNE ...
L
R
?
JUNE ...
No comments !!!!!!!
Venous occlussion !!!!!!!
JUNE ...
Simple system removal
www.usuwanieelektrod.pl a_kutarski@yahoo.com
JUNE ... Sixth hospitalisation: complete system extraction ď Š
There is no partial system extraction; one infected lead ... ALL leads MUST to be extracted !!!!!!!!!
JULY ...
AUGUST ...
Seventh hospitalisation: the new AAI system impantation
HOME ...
There is no partial system extraction; one infected lead ... and ALL leads have to be been extracted !!!!!!!!! Even implanted opposite side of the chest www.usuwanieelektrod.pl a_kutarski@yahoo.com
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a_kutarski@yahoo.com www.usuwanieelektrod.pl