Retrieval of the retained intervention guide wire from deltoid muscle- A
rare and delayed presentation post cardiac resynchronization therapy
(CRT-D) lead replacement.
Abstract
Background and Aims- A fracture and retention of guidewire after cardiac
resynchronization therapy device implant has not been reported so far,
although it is an uncommon but known complication during cardiac
interventions like percutaneous coronary interventions and other cardiac
catheterization procedures. Methods- A 53 years old female patient
presented to us, who had been diagnosed as a case of dilated
cardiomyopathy with severe left ventricular dysfunction and underwent
cardiac resynchronization therapy (CRT-D) device implant three years
back and subsequently underwent lead replacement 6 months back due to
lead dysfunction, with severe pain over the left arm and shoulder for
last 1-2 days. On evaluation, it was found that she had a coronary
guidewire which might have fractured and retained inadvertently in
previous surgical procedure and has caused her symptoms that might have
been aggravated by the movements of her arm. Emergency surgical
exploration was done and the guidewire which was impacted in deltoid
muscle was removed. Results, and Conclusion- We are reporting the case
due to a very unlikely and unusual delayed presentation of retained
intervention guide-wire post cardiac resynchronization therapy,
retrieved from left deltoid muscle.