case_images: PMC11737912_01
case_images: Posterior-anterior (A) and lateral (B) chest X-rays showing a dual chamber pacemaker generator located in the left antero-lateral chest wall, with the transvenous lead tips located into the right atrial appendage (full arrows) and right ventricular apex (empty arrows), respectively. Multiple abandoned epicardial pacemaker leads along the cardiac surface is also detectable (arrowheads).
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case_images: Chest X-ray (CXR) documented no acute cardiopulmonary findings (Figure 1).
case_images: 3D volume rendered coronary computed tomography angiography images clearly show multiple epicardial pacemaker leads constricting the apical and posterior-lateral free wall of the left ventricular, crossing the course of the distal first diagonal branch (arrows in A and B) and the mid-left-circumflex artery (arrowheads in C).
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case_images: PMC11737912_01_ytae688f2.jpg
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case_images: The remaining coronary arteries had no stenosis (Figures 2 and 3).
case_images: Curved (A, B) and stretched (C) multi-planar coronary computed tomography angiography reconstructions clearly show the segmental occlusion (arrows) of mid-left-circumflex artery due to extrinsic compression by a solid tissue (arrowheads in B and C) grown along the contiguous and abandoned epicardial lead.
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case_images: PMC11737912_01_ytae688f3.jpg
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case_images: The remaining coronary arteries had no stenosis (Figures 2 and 3).
case_images: Invasive coronary angiography shows the chronic occlusion of mid-left-circumflex artery (full arrows) at the level of the overlapped epicardial lead (empty arrow), with distal homocoronary collateral circulation (arrowheads). Transvenous right ventricular (*) and atrial (**) leads are shown.
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case_images: PMC11737912_01_ytae688f4.jpg
case_images: ytae688-F4