Image in Cardiology
A right ventricular perforation
Uma perfuração do ventrículo direito
Sofia Lázaro Mendes
, Luís Elvas, Domingos Ramos, Mariano Pêgo
Corresponding author
Hospitais da Universidade de Coimbra – Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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"227" "paginaFinal" => "228" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sofia Lázaro Mendes, Luís Elvas, Domingos Ramos, Mariano Pêgo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Sofia" "apellidos" => "Lázaro Mendes" "email" => array:1 [ 0 => "sofialazaromendes@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Luís" "apellidos" => "Elvas" ] 2 => array:2 [ "nombre" => "Domingos" "apellidos" => "Ramos" ] 3 => array:2 [ "nombre" => "Mariano" "apellidos" => "Pêgo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospitais da Universidade de Coimbra – Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Uma perfuração do ventrículo direito" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1408 "Ancho" => 1627 "Tamanyo" => 223436 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest radiography: progression of the right ventricular lead beyond the cardiac silhouette.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 73-year-old woman with non-ischemic cardiomyopathy and left bundle branch block underwent implantation of a biventricular cardioverter-defibrillator with an active fixation, single-coil right ventricular lead. The procedure was without complications.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Three weeks later, she presented to the emergency department with complaints of pleuritic chest pain and shortness of breath. Her blood pressure was 100/40<span class="elsevierStyleHsp" style=""></span>mmHg, oxygen saturation was 100% on room air and temperature was 38.2<span class="elsevierStyleHsp" style=""></span>°C. Chest auscultation was normal and revealed no adventitious sounds. A chest radiograph demonstrated progression of the right ventricular lead beyond the cardiac silhouette (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), without hemothorax. Pericardial effusion was excluded. On interrogation of the device, reduced sensing amplitude was found.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Three sets of blood cultures were drawn before initiation of antimicrobial therapy with linezolid. <span class="elsevierStyleItalic">Staphylococcus aureus</span> was subsequently isolated.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We decided to extract the device since the patient had presented with fever and blood cultures were positive. Surgical backup was arranged and the pulse generator and leads were extracted by direct traction in the operating room with close echocardiographic monitoring. There was no pericardial effusion.</p><p id="par0025" class="elsevierStylePara elsevierViewall">She remained stable and was discharged after a few weeks. Implantation of a new device was planned.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-03-19" "fechaAceptado" => "2016-06-13" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1408 "Ancho" => 1627 "Tamanyo" => 223436 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest radiography: progression of the right ventricular lead beyond the cardiac silhouette.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003600000003/v1_201703240113/S217420491730065X/v1_201703240113/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003600000003/v1_201703240113/S217420491730065X/v1_201703240113/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217420491730065X?idApp=UINPBA00004E" ]
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