Value of a Joint Cardiac Surgery-Cardiac Electrophysiology Approach to Lead Extraction
Breno Bernardes de Souza1, Peyman Benharash2, Fardad Esmailian2
1UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
Insights
Vascular injury during laser lead extraction requires urgent surgery. A collaborative approach with cardiac surgeons and electrophysiologists ensures patient survival and optimal outcomes.
Area of Science:
- Cardiovascular Surgery
- Electrophysiology
- Medical Device Management
Background:
- Laser lead extraction is a procedure to remove implanted cardiac electronic device leads.
- Vascular complications, though rare, can occur during lead extraction procedures.
- Prompt management is crucial for favorable patient outcomes.
Observation:
- Three patients experienced vascular injury during laser lead extraction.
- These injuries necessitated immediate surgical intervention.
- The institution has a collaborative model for these procedures.
Findings:
- Urgent sternotomy and cardiopulmonary bypass were successfully employed in all three cases.
- The collaborative approach between cardiac surgeons and cardiac electrophysiologists facilitated immediate intervention.
- All patients undergoing this joint procedure survived.
Implications:
- A joint surgical and electrophysiology approach may be the optimal strategy for managing laser lead extraction complications.
- This collaborative model enhances patient safety during complex lead extraction procedures.
- The findings support the integration of surgical and electrophysiological expertise for high-risk cardiac device interventions.
Abstract:
We report three cases of vascular injury during laser lead extractions, requiring urgent surgical correction. Immediate sternotomy and cardiopulmonary bypass were possible because of an institutional collaboration where cardiac surgeon and cardiac electrophysiologist jointly perform these cases, and all patients survived. We propose this joint approach is ultimately the best option for patients undergoing lead extraction.
More Related Videos
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
09:52Optocardiography and Electrophysiology Studies of Ex Vivo Langendorff-perfused Hearts
Published on: November 7, 2019
Related Concept Videos
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
01:24Cardiac Catheterization III: Left Heart Catheterization
01:28Cardiac Catheterization I: Pre-Procedure Overview