Pacemaker leads: a simple atraumatic method for replacing pacemaker electrodes.

Early dislodgment or malfunction of pacemaker leads can result in significant morbidity and therefore must be corrected promptly. We describe a method of changing pacemaker leads that is atraumatic, maintains central venous access, and eliminates the need for venipuncture. Our technique is simple, highly reproducible, and can be performed with standard operating room instruments.

Leiomyosarcoma of the pulmonary vein.

Objective: We report a case of leiomyosarcoma (LMS) of the pulmonary vein and comment on the natural history and determinants for survival for this rare condition.

Experimental Design: Our retrospective review is only the fourth such case reported in the world's literature.

Setting: A teaching hospital with an active surgical residency program.

Central venous puncture versus cutdown for permanent pacemaker lead insertion: a modified double introducer technique.

Objective: The comparative safety of central venous puncture versus cutdown technique for access to the right heart.

Experimental Design: A retrospective review of five hundred and fifty-five single and dual chamber permanent pacemaker implants performed between January of 1987 and December of 1993.

Setting: Review was performed at St.

Case study: gluteal abscess due to Crohn's disease.

Spontaneous retroperitoneal abscess as a result of Crohn's disease does not always terminate at the psoas or iliac spaces. The abscess may continue downward breaching the obturator fascia. Passage through the sciatic foramina can result in a buttock or posterior upper thigh abscess.