Safety Outcomes of Hybrid Open Chest Transvenous Lead Extraction: A Multicenter Experience

Area of Science:

• Cardiovascular Surgery
• Electrophysiology
• Medical Device Extraction

Background:

• Hybrid open chest transvenous lead extraction (TLE) combines surgical and endovascular methods for complex cases.
• Data on outcomes for TLE in patients needing cardiac surgery or with high-risk features is limited.

Purpose of the Study:

• To assess procedural outcomes of elective hybrid open chest TLE.
• To identify predictors of complications in patients undergoing this procedure.

Main Methods:

• Retrospective multicenter cohort study of 40 patients (2017-2025).
• Exclusion of emergency surgical conversions.
• Analysis of baseline, procedural, and outcome data, including in-hospital mortality and complications (modified Delphi classification).
• Logistic regression used to identify complication predictors.

Main Results:

• High clinical procedural success (97.5%) with low in-hospital mortality (2.5%).
• Severe complication rate was 15%, overall complication rate was 37.5%.
• Chronic lung disease predicted severe complications (OR 102.2, p=0.03); atrial fibrillation predicted any complication (OR 5.83, p=0.04).

Conclusions:

• Hybrid open chest TLE offers high success with acceptable mortality despite significant morbidity.
• Chronic lung disease is an independent predictor of complications, crucial for patient selection and planning.