Misplaced Ventricular Lead via an Atrial Septal Defect-Percutaneous Extraction
Jerry Easo1, Malte Book2, Samer Hakmi3
1Department of Cardiac Surgery, University Clinic Oldenburg, European Medical School Oldenburg-Groningen, Oldenburg, Germany.
The Thoracic and Cardiovascular Surgeon Reports
|April 24, 2019
Summary
Percutaneous lead removal using rotational sheaths is a viable option for abandoned defibrillator leads, even after 12 years. This technique minimizes emboli risk and avoids high-risk surgical procedures.
Area of Science:
- Cardiology
- Medical Devices
- Interventional Cardiology
Background:
- A 45-year-old woman required lead removal after 12 years due to mitral valve regurgitation.
- The regurgitation was caused by a misplaced defibrillator lead retracting the posterior leaflet.
Observation:
- The patient had a history of multiple cardiac surgeries.
- An abandoned defibrillator lead was present via a patent atrial septal defect.
Findings:
- Lead extraction was performed using rotational dilating sheaths, a novel technique.
- This method aimed to reduce the risk of emboli.
- The procedure successfully avoided a fourth high-risk surgical intervention.
Implications:
- Percutaneous lead removal with rotational sheaths is feasible for long-dwelling, misplaced leads.
- This approach offers an acceptable operative risk profile.
- It presents a less invasive alternative to open surgery for complex lead extractions.
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