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Transvenous lead extraction in patients with persistent left superior vena cava
Antonio Curnis1, Mohamed Aboelhassan1,2, Manuel Cerini1
1Cardiology Department, Spedali Civili Brescia, Brescia, Italy.
Journal of Cardiovascular Electrophysiology
|March 30, 2021
Summary
Transvenous lead extraction (TLE) in patients with a persistent left superior vena cava (PLSVC) can be performed successfully. These procedures may require fewer tools than anticipated, even with older leads.
Area of Science:
- Cardiology
- Medical Devices
- Anatomy
Background:
- Venous anatomical variations can impact cardiac device procedures.
- Persistent left superior vena cava (PLSVC) is a common anomaly that may complicate transvenous lead extraction (TLE).
- Limited data exists on TLE outcomes in patients with PLSVC.
Purpose of the Study:
- To describe the technical considerations and outcomes of TLE in patients with leads implanted via PLSVC.
- To evaluate the feasibility and safety of TLE in the context of this specific venous anomaly.
Main Methods:
- Case report of two patients with isolated PLSVC requiring TLE.
- One patient underwent TLE in a hybrid operating room with thoracoscopic monitoring.
- Extraction of leads without advanced tools or locking stylets in one case.
Main Results:
- Successful TLE was achieved in both patients with isolated PLSVC.
- Procedures were less complex than expected, despite lead age and fixation type.
- No procedural complications or adverse events were noted at 1-year follow-up.
Conclusions:
- Transvenous lead extraction in patients with PLSVC is feasible and can be less challenging than anticipated.
- Experienced centers should consider TLE for patients with PLSVC when indicated.
- This anomaly does not necessarily preclude successful lead removal.
Keywords:
ICD lead extractioncoronary sinus lead extractionhybrid lead extractionpersistent left superior vena cavatransvenous lead extractionMore Related Videos
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