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Migliore F, Tarzia V, Dall'Aglio PB, Falzone PV, De Lazzari M, Bottio T, D'Onofrio A, Padalino M, Vida V, Rosso J, Leoni L, Pittarello D, Bertaglia E, Iliceto S, Gerosa G. The valuable interaction among cardiac surgeon and electrophysiologist for transvenous rotational mechanical lead extraction. Pacing Clin Electrophysiol 2021; 45:92-102. [PMID: 34699079 DOI: 10.1111/pace.14396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/23/2021] [Accepted: 10/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Recent studies have shown that Evolution RL bidirectional rotational mechanical sheath (Cook Medical,USA) is an effective and safe technique for transvenous lead extraction (TLE). We reported our experience with the bidirectional rotational mechanical tools using a multidisciplinary approach highlighting the value of a joint cardiac surgeon and electrophysiologist collaboration. METHODS The study population comprised 84 patients (77%male;mean age 65±18 years) undergoing TLE.After multidisciplinary evaluation, a combined procedure was considered. RESULTS The main indication for TLE was infection in 54 cases (64%).Overall,152 leads were extracted with a mean implant duration of 94±63 months (range 12-421).Complete procedural success rate, clinical success rate, and lead removal with clinical success rate were 91.6 % (77/84),97.6% (82/84), and 98.6%(150/152), respectively.Eighteen combined procedure were performed in 12 patients (14%), such as "hybrid approach" (n = 2) or TLE concomitant to:1) transcatheter aspiration procedure for large vegetation (n = 8); 2) left ventricular assistance device implantation as bridge to cardiac transplantation (n = 1); 3) permanent pacing with epicardial leads (n = 6); 4) tricuspid valve replacement (n = 1).One major complication (1.2%) and 11 (13%) minor complications were encountered.No injury to the superior vena cava occurred and no procedure-related deaths were reported. During a mean time follow-up of 21±18 months, 17 patients (20%) died.They were more often diabetics (P = 0.02), and they underwent TLE more often for infection (P = 0.004). CONCLUSIONS Our results support the finding that excellent outcomes can be achieved in performing TLE of chronically implanted leads by using the Evolution RL bidirectional rotational mechanical sheath and a multidisciplinary team approach involving both electrophysiologist and cardiac surgeon as first line operators. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Federico Migliore
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Vincenzo Tarzia
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | | | - Pasquale Valerio Falzone
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Manuel De Lazzari
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Tomaso Bottio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Augusto D'Onofrio
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Massimo Padalino
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Vladimiro Vida
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Jacopo Rosso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Loira Leoni
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Demetrio Pittarello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Sabino Iliceto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Italy
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Dhawan R, Khan F, Samant S, Asawaeer M, Merritt Genore H, Erickson CC. A 37-Year-Old Woman with Hypertrophic Cardiomyopathy with a Dual-Chamber Implantable Cardioverter-Defibrillator Requiring Percutaneous Transvenous Lead Extraction and Multidisciplinary Management. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932073. [PMID: 34675166 PMCID: PMC8546269 DOI: 10.12659/ajcr.932073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Patient: Female, 37-year-old
Final Diagnosis: Hypertrophic cardiomyopathy
Symptoms: None
Medication:—
Clinical Procedure: Percutaneous ICD lead extraction • Surgical ICD lead extraction
Specialty: Cardiac Electrophysiology • Cardiac Surgery • Cardiology
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Affiliation(s)
- Rahul Dhawan
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Faris Khan
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Saurabhi Samant
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Majid Asawaeer
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - HelenMari Merritt Genore
- Department of Surgery, Division of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Christopher C Erickson
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Ayvazyan SA, Gamzaev AB, Palagina AA, Gorshenin KG, Buslaeva SI, Seregin AA, Konovalov NS, Sapelnikov OV. The Use of Transvenous Lead Extraction of Non-Infected Leads to Prevent Long-Term Lead-Related Complications. Sovrem Tekhnologii Med 2021; 13:66-69. [PMID: 34513068 PMCID: PMC8353688 DOI: 10.17691/stm2021.13.1.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Indexed: 12/02/2022] Open
Abstract
The aim of the investigation was to study the issue of making challenging decisions concerning abandonment or removal of non-infected superfluous leads during lead revisions or cardiac implantable electronic device upgrades.
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Affiliation(s)
- S A Ayvazyan
- Cardiovascular Surgeon, Volga District Medical Centre of Federal Medical Biological Agency of Russia, 2 Nizhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603001, Russia
| | - A B Gamzaev
- Professor, Department of X-ray Surgical Methods of Diagnosis and Treatment, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A A Palagina
- Resident, Department of X-ray Endovascular Diagnostics and Treatment, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - K G Gorshenin
- Cardiologist, Volga District Medical Centre of Federal Medical Biological Agency of Russia, 2 Nizhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603001, Russia
| | - S I Buslaeva
- Cardiologist, Volga District Medical Centre of Federal Medical Biological Agency of Russia, 2 Nizhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603001, Russia
| | - A A Seregin
- Endovascular Surgeon, Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment, Volga District Medical Centre of Federal Medical Biological Agency of Russia, 2 Nizhne-Volzhskaya naberezhnaya, Nizhny Novgorod, 603001, Russia
| | - N S Konovalov
- Resident, Department of X-ray Surgical Methods of Diagnosis and Treatment, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - O V Sapelnikov
- Cardiovascular Surgeon, Department of Cardiovascular Surgery, National Medical Research Center of Cardiology, 15a, 3 Cherepkovskaya St., Moscow, 121552, Russia
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Ksela J, Prevolnik J, Racman M. Transvenous lead extraction outcomes using a novel hand-powered bidirectional rotational sheath as a first-line extraction tool in a low-volume centre. Interact Cardiovasc Thorac Surg 2021; 32:395-401. [PMID: 33249479 DOI: 10.1093/icvts/ivaa286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 10/04/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Extraction of cardiovascular implantable electronic devices in low-volume medical centres with limited clinical experience and an evolving lead extraction programme may be challenging. We aimed to evaluate the safety and efficacy of stepwise transvenous lead extraction (TLE) using a novel type of hand-powered rotational sheath as a first-line tool for extraction of chronically implanted devices in a single, low-volume centre. METHODS Sixty-seven consecutive patients undergoing a TLE procedure using the novel Evolution® RL rotational sheath as the first-line extraction tool between 2015 and 2019 at our institution were enrolled in the study. Their short-term and 30-day outcomes were observed. RESULTS Sixty-nine devices and 131 leads were explanted. Procedural and clinical success rates were 92.4% and 98.5%, respectively. Two procedures were classified as failures due to lead remnants >4 cm remaining in patients' vascular systems. One major (1.5%) and 3 minor (4.4%) adverse events and no deaths were observed. CONCLUSIONS TLE procedures, performed in a stepwise manner, using the Evolution RL sheath as a first-line extraction device and conducted by an experienced, surgically well-trained operator, offer excellent results with clinical and procedural success rates comparable to those, achieved in dedicated, high-volume institutions. Opting for optimal lead extraction approach in low-volume centres or institutions with evolving TLE programmes, a stepwise extraction strategy using the Evolution RL sheath by skilled operator may provide the optimal scheme with an excellent ratio between clinical and/or procedural success and complications.
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Affiliation(s)
- Jus Ksela
- Department of Cardiovascular Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia.,Department of Surgery, Faculty of Medicine, Ljubljana, Slovenia
| | - Jan Prevolnik
- Department of Surgery, Faculty of Medicine, Ljubljana, Slovenia
| | - Mark Racman
- Department of Cardiovascular Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia
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Hasumi E, Fujiu K, Masae U, Hoshino Y, Kinoshita O, Ono M, Komuro I. Hybrid Lead Extraction Technique: Combined Transatrial Laser Lead Extraction and Surgical Removal of Calcified Lesions. JACC Case Rep 2019; 1:281-286. [PMID: 34316808 PMCID: PMC8289155 DOI: 10.1016/j.jaccas.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 06/13/2023]
Abstract
This report presents a new hybrid lead extraction technique combined with transatrial laser lead extraction and surgical removal of calcified lesions in a 50-year-old man with superior vena cava syndrome and bilateral subclavian vein occlusion caused by an abandoned lead, which had been infected for 11 years. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Eriko Hasumi
- Department of Ubiquitous Health Informatics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
- Department of Advanced Cardiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Uehara Masae
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yasuhiro Hoshino
- Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Osamu Kinoshita
- Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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Migliore F, Testolina M, Sagone A, Carretta D, Agricola T, Rovaris G, Piazzi E, Facchin D, Lazzari M, Zorzi A, Melillo F, Cataldi C, Marzi A, Bottio T, Tarzia V, Gerosa G, Iliceto S, Bertaglia E, Mazzone P. Multicenter experience with the Evolution RL mechanical sheath for lead extraction using a stepwise approach: Safety, effectiveness, and outcome. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 42:989-997. [DOI: 10.1111/pace.13700] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/18/2019] [Accepted: 04/15/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Federico Migliore
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Martina Testolina
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Antonio Sagone
- Policlinico IRCCS Multimedica Sesto San Giovanni Milano Italy
| | - Domenico Carretta
- Unit of Cardiovascular Diseases, Azienda Ospedaliera UniversitariaOspedale Policlinico Consorziale Bari Italy
| | - Tullio Agricola
- Electrophysiology Unit“Spirito Santo” Hospital Pescara Italy
| | - Giovanni Rovaris
- Interventional Electrophysiology UnitSan Gerardo Hospital Monza Italy
| | - Elena Piazzi
- Interventional Electrophysiology UnitSan Gerardo Hospital Monza Italy
| | | | - Manuel Lazzari
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Alessandro Zorzi
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Francesco Melillo
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology LaboratoriesOspedale San Raffaele Milan Italy
| | - Claudia Cataldi
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Alessandra Marzi
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology LaboratoriesOspedale San Raffaele Milan Italy
| | - Tomaso Bottio
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Vincenzo Tarzia
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Gino Gerosa
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Sabino Iliceto
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Emanuele Bertaglia
- Department of Cardiac, Thoracic and Vascular SciencesUniversity of Padova Padova Italy
| | - Patrizio Mazzone
- Department of Cardiology and Cardiothoracic Surgery, Arrhythmia Unit and Electrophysiology LaboratoriesOspedale San Raffaele Milan Italy
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7
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Segreti L, Giannotti Santoro M, Di Cori A, Zucchelli G, Viani S, De Lucia R, Della Tommasina V, Barletta V, Paperini L, Soldati E, Bongiorni MG. Utility of risk scores to predict adverse events in cardiac lead extraction. Expert Rev Cardiovasc Ther 2018; 16:695-705. [DOI: 10.1080/14779072.2018.1513325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Luca Segreti
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Mario Giannotti Santoro
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Andrea Di Cori
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Giulio Zucchelli
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Stefano Viani
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Raffaele De Lucia
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Veronica Della Tommasina
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Valentina Barletta
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Luca Paperini
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Ezio Soldati
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Maria Grazia Bongiorni
- Second Division of Cardiovascular Diseases, Cardiac and Thoracic Department, New Santa Chiara Hospital, University of Pisa, Pisa, Italy
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