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Concurrent Epicardial Cardiac Resynchronization at Time of Complicated Biventricular Device Extraction: A Potentially
Nicolas Bergeron1, Valérie Lafrenière-Bessi1, Maxime Laflamme1
1Cardiac Surgery Division, Multidisciplinary Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, Laval, Québec, Canada.
Insights
Transvenous lead extraction for cardiac resynchronization therapy defibrillator (CRT-D) endocarditis complicated by cardiac injury was successfully managed with epicardial device reimplantation, restoring hemodynamic stability.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Medical Device Technology
Background:
- Cardiac resynchronization therapy defibrillator (CRT-D) lead endocarditis presents a significant clinical challenge.
- Transvenous lead extraction (TLE) is a primary treatment, but complications can arise, necessitating alternative strategies.
Abstract:
A 60-year-old man with cardiac resynchronization therapy defibrillator (CRT-D) lead endocarditis underwent transvenous lead extraction that was complicated by coronary sinus laceration and tamponade. Severe left ventricular dysfunction and unstable hemodynamic parameters persisted after emergent sternotomy, drainage, and repair. Reinstitution of cardiac resynchronization therapy with an epicardial device resulted in immediate hemodynamic improvement. Our case illustrates the potentially life-saving nature of single-stage extraction and reimplantation in resynchronization responders.
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