2026, Number 2
Cir Card Mex 2026; 11 (2)
Comprehensive approach of patients with cardiac perforation and management of difficult airway: case report
Jiménez-González, Reynaldo J; Ogaz-Escarpita, María C; Castañón-Colunga, Edwin A; Carrera-Baca, Mauricio; Aguilar-Romero, Jesús D; Marmolejo-Rivera, Rigoberto; García-Villarreal, Ovidio A
ABSTRACT
Myocardial perforation related to cardiac pacemakers is a rare but potentially fatal complication. Risk factors such as active fixation electrodes, steroid use, advanced age, female sex, comorbidities, and apical electrode placement confer a higher risk. We report the case of an 83-year-old woman who experienced cardiac perforation two years after pacemaker implantation, caused by electrode migration. Her advanced age and non-septal electrode placement were identified as risk factors. The patient underwent successful surgical repair via anterior thoracotomy, with hybrid intubation employed due to a predicted difficult airway. She exhibited favorable clinical progress and was discharged after a one-week hospital stay. The hybrid intubation technique, although more commonly used in pediatrics, proved useful in this adult patient with predictors of a difficult airway.