Transvenous Lead Extraction without Procedure-Related Deaths in 1000 Consecutive Patients: A Single-Center Experience.
Adolescent
Adult
Aged
Aged, 80 and over
Defibrillators, Implantable
/ adverse effects
Device Removal
/ methods
Echocardiography
Female
Humans
Male
Middle Aged
Pacemaker, Artificial
/ adverse effects
Pregnancy
Retrospective Studies
Treatment Outcome
Tricuspid Valve
/ diagnostic imaging
Universal Precautions
complications of lead extraction
lead extraction
mechanical dilatation
safety precautions
venue of TLE
Journal
Vascular health and risk management
ISSN: 1178-2048
Titre abrégé: Vasc Health Risk Manag
Pays: New Zealand
ID NLM: 101273479
Informations de publication
Date de publication:
2021
2021
Historique:
received:
30
04
2021
accepted:
17
06
2021
entrez:
13
8
2021
pubmed:
14
8
2021
medline:
25
12
2021
Statut:
epublish
Résumé
Transvenous lead extraction (TLE) is now a first-line technique for the treatment of complications related to cardiac implantable electronic devices. The aim of the study was to demonstrate that it is possible to safely perform difficult TLE procedures with a maximum reduction of peri-procedural major complications. A total of 1000 consecutive patients undergoing TLE in a single high-volume center from 2016 to 2019 were studied. All procedures were performed in a hybrid room or operating room by a specialized TLE team. TLE was performed under general anesthesia and monitored by transesophageal echocardiography, and the operating room was suitably equipped for immediate surgical intervention. The effectiveness and safety of the procedures were assessed, with particular emphasis on major complications. In all, 1952 leads with the mean implant duration of 111.7 ± 77.6 months had been extracted. Complete procedural success of patients was achieved in 95.9% and clinical success in 99.1%. Major complications, predominantly cardiac tamponade (63.3%), occurred in 22 patients (2.2%). Rapid diagnosis and immediate intervention were the key to a 100% survival in patients with this complication. Performing procedures in a hybrid operating room under general anesthesia in the presence of a cardiac surgeon and with the use of transesophageal echocardiography significantly improves the safety of transvenous lead extraction.
Sections du résumé
BACKGROUND
BACKGROUND
Transvenous lead extraction (TLE) is now a first-line technique for the treatment of complications related to cardiac implantable electronic devices. The aim of the study was to demonstrate that it is possible to safely perform difficult TLE procedures with a maximum reduction of peri-procedural major complications.
METHODS
METHODS
A total of 1000 consecutive patients undergoing TLE in a single high-volume center from 2016 to 2019 were studied. All procedures were performed in a hybrid room or operating room by a specialized TLE team. TLE was performed under general anesthesia and monitored by transesophageal echocardiography, and the operating room was suitably equipped for immediate surgical intervention. The effectiveness and safety of the procedures were assessed, with particular emphasis on major complications.
RESULTS
RESULTS
In all, 1952 leads with the mean implant duration of 111.7 ± 77.6 months had been extracted. Complete procedural success of patients was achieved in 95.9% and clinical success in 99.1%. Major complications, predominantly cardiac tamponade (63.3%), occurred in 22 patients (2.2%). Rapid diagnosis and immediate intervention were the key to a 100% survival in patients with this complication.
CONCLUSION
CONCLUSIONS
Performing procedures in a hybrid operating room under general anesthesia in the presence of a cardiac surgeon and with the use of transesophageal echocardiography significantly improves the safety of transvenous lead extraction.
Identifiants
pubmed: 34385818
doi: 10.2147/VHRM.S318205
pii: 318205
pmc: PMC8352641
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
445-459Informations de copyright
© 2021 Stefańczyk et al.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest in this work.
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