Lead jumbled inside heart.

[zokmonky]

My mom Just found out a couple weeks ago that she had a lead wire to her pacemaker that was "cracked".  She was scheduled for surgery last night.  Right before they started to operate, after she'd been put under, they did something that allowed them to see that the wire wasn't just "cracked".  Her lead was broken about an inch from the pacemaker and all of the remaining lead had followed the natural path that the blood takes and was all coiled up inside her heart.  So needless to say she didn't have her surgery and she is supposed to see a different surgeon who can do something.  But what, we have yet to been told.  I can't find anything online about this type of problem and I was wondering if anyone else had had this happen to them or if they knew anyone who had been through this.  

[Jerry_NJ]

Seems not such experience here.  It does seem to be, I hope, very/very unusual.

The fact that it wasn't even, it appears, on the possibility list by the doctor(s) scheduling the lead reconnect.  

Not being an expert, I can't even imagine how the lead could end up inside the heart, I thought the leads connected to a muscle, so it could stimulate that muscle...i.e., inject an electrical signal into the heart muscle(s) to cause a contraction.

Let us know how this develops, it looks like you've got a "new one" here.

[stevie_wonder]

I'm so sorry to hear that this happened to your mom. How old is she? I just had an ICD implanted and I had asked the surgeon who implanted it what would happen if the lead fractured. He told me that in most instances it could be removed without open heart surgery but that in very rare cases open heart surgery is needed. I hope this isn't the case for your mother but google "lead extraction" and you will find alot of info, but don't let it scare you. I had also just read an article stating that sometimes it is okay to leave fractured leads in the heart. It sounds like you are in good hands since they are talking to a different surgeon.
Good Luck!

[zokmonky]

My mom is 52.  She's had her pacemaker for 4 1/2 years now.  Fractures, while rare, are fixable.  the original plan was that hers was fractured.  So the procedure would be to snip both ends, cap them and sew them down, and then implant the new lead in another spot close by.  In that procedure you do not have to have open heart surgery.  It's much like the original surgery where you get the pacemaker.  They go in through the original scar site and fix everything and finish up.  The doc said that she would have this is different because you would need full access to the heart, hence the open heart part.  We scary thing is that he doesn't know how to go about it, and he's never heard or seen a case like hers.  We go tomorrow to talk to the #2 surgeon ( the # 1 surgeon just had heart surgery performed by the #2 surgeon, so she can't get the #1).  He is supposed to talk with us and give us his plan of action and schedule her surgery date.  The weird thing in her case that I can't find anywhere is that her lead isn't just cracked, it completely broke for no apparent reason.  I'm not so nervous about the open heart part, but I wish I had the comfort of knowing what the plan of action is and if it's been successfully done before.  I do know they don't want to do lead extraction because it is very dangerous.  And I don't know how old the info is that i've been reading but everything i've seen says that there aren't the extraction tools in the US to  perform an extraction.  If anyone hears anything similar to her case, keep me posted.  I will keep you updated as to what the doc says next.  

[PikaPika88]

I had my leaking lead cap and coil in my chest.  Then they implanted 2 new leads for me.  That was back in 1994.  It should has some stitches when it enters into the veins to hold it position and avoid the tear unless they forgot to stitch up from there!  Ask Dr McWilliams.

[zokmonky]

Phew,   We went to the doc this past Friday.  Got some good news.  He thinks that he can go in through her groin and get it out.  He will have to grab the lead and unscrew it and then pull it out.  If it doesn't come out he will have to pull.  If it still doesn't come out he will have to pull harder causing a hole in her heart.  If that happens he will then have to do the open heart to patch up her heart and go ahead and finish the pacemaker swap and new lead.  If however everything goes as planned, he will just have to go in through the groin, get the lead out, then go in her pacemaker site and swap out the pacemaker and put in the new lead.  That way is MUCH better, no open heart surgery and recovery time would just be a matter of days instead of weeks.  The doc said he'd seen 3 cases similar to hers in the past 10 years and everything went great with them.  Her surgery is this Wednesday the 4th.  

[Jerry_NJ]

We all pray that the extraction of the lead goes well, simplest and fastest way possible.

These are traumatic things, but thankfully they are "just business as usual" for an experienced doctor, the best type to have.  

[zokmonky]

YEA!  I'm in the hospital right now, spending the night and watching over her.  She did great and the doctor did awesome.  He was able to get everything out without a problem and he even readjusted the working lead to a better, more efficient location.  She is drowsy but they say she'll probably be able to go home tomorrow.  I'm amazed at how far they have come.  No open heart surgery... YEA!!

[lulama]

Thank you !.......for posting that good news........It's just great to hear about good outcomes......God bless you and your Mom and your good doctors.........