Pectoral Sandwich Flap to Salvage Implanted Pacemaker Device - A Case Series

Vijay Bhatia1*, Anoop Gupta2, Sruja Narola3, Ranjit Zapadiya3, Rahul Kaushik3 and Archana Thakur3

Vijay Bhatia1*, Anoop Gupta2, Sruja Narola3, Ranjit Zapadiya3, Rahul Kaushik3 and Archana Thakur3

^*Correspondance to: Vijay Bhatia 

 PDF  Full Text Surgical Technique | Open Access

Abstract:

Introduction: Cardiac pacemakers, defibrillators and Cardiac resynchronization therapies are
very common in current era. These devices are susceptible to erosion, exposure, or infection and
plastic surgeons are consulted when salvage is required. As of yet, subpectoral position (by lateral
repositioning approach or an anterior muscle splitting approach) and intrapectoral position to
effectively and safely relocate the device have been described.
Methods: Twelve patients required surgical intervention for cardiac devices over period of Four
years (from August 2013 to August 2017) for exposure, erosion, potential infection, and fat necrosis
within 3 to 15 months of primary impanation, none of the patients were treated for impeding
erosion or cosmetic reasons.
Results: All patients were treated with pectoral muscle turn over technique to salvage the device.
All the patients were culture (three cultures) negative for bacterial growth from device surface or
pocket discharge. Eleven of 12 patients (91.6%) achieved successful long-term coverage in the same
pocket with turnover muscle flap without recurrent exposure or hematoma and with good cosmetic
results. One patient required pacemaker explantation and re-implant from the opposite side due to
underlying infection.
Conclusion: The turn over muscle flap technique proposed by the authors for defibrillator or
pacemaker salvage is a feasible technique with promising results.

Keywords:

The turn over pectoral muscle flap; Salvage surgery; Implantable devices

Cite the Article:

Bhatia V, Gupta A, Narola S, Zapadiya R, Kaushik R, Thakur A. Pectoral Sandwich Flap to Salvage Implanted Pacemaker Device - A Case Series. World J Surg Surgical Res. 2021; 4: 1330..