Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage

Łukasz Tułecki, Anna Polewczyk, Wojciech Jacheć, Dorota Nowosielecka, Konrad Tomków, Paweł Stefańczyk, Jarosław Kosior, Krzysztof Duda, Maciej Polewczyk and Andrzej Kutarski
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Łukasz Tułecki: Department of Cardiac Surgery, The Pope John Paul II Province Hospital of Zamość, 22-400 Zamość, Poland
Anna Polewczyk: Department of Physiology, Pathophysiology and Clinical Immunology Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
Wojciech Jacheć: 2nd Department of Cardiology, Silesian Medical University, 41-808 Zabrze, Poland
Dorota Nowosielecka: Department of Cardiology, The Pope John Paul II Province Hospital of Zamość, 22-400 Zamość, Poland
Konrad Tomków: Department of Cardiac Surgery, The Pope John Paul II Province Hospital of Zamość, 22-400 Zamość, Poland
Paweł Stefańczyk: Department of Cardiology, The Pope John Paul II Province Hospital of Zamość, 22-400 Zamość, Poland
Jarosław Kosior: Department of Cardiology, Masovian Specialist Hospital of Radom, 26-617 Radom, Poland
Krzysztof Duda: Department of Cardiac Surgery, Masovian Specialist Hospital of Radom, 26-617 Radom, Poland
Maciej Polewczyk: Faculty of Medicine and Health Studies, Jan Kochanowski University, 25-369 Kielce, Poland
Andrzej Kutarski: Department of Cardiology, Medical University of Lublin, 20-509 Lublin, Poland

IJERPH, 2021, vol. 18, issue 17, 1-13

Abstract: Background: Transvenous lead extraction (TLE) is a relatively safe procedure, but it may cause severe complications such as cardiac/vascular wall tear (CVWT) and tricuspid valve damage (TVD). Methods: The risk factors for CVWT and TVD were examined based on an analysis of data of 1500 extraction procedures performed in two high-volume centers. Results: The total number of major complications was 33 (2.2%) and included 22 (1.5%) CVWT and 12 (0.8%) TVD (with one case of combined complication). Patients with hemorrhagic complications were younger, more often women, less often presenting low left ventricular ejection fraction (LVEF) and those who received their first cardiac implantable electronic device (CIED) earlier than the control group. A typical patient with CVWT was a pacemaker carrier, having more leads (including abandoned leads and excessive loops) with long implant duration and a history of multiple CIED-related procedures. The risk factors for TVD were similar to those for CVWT, but the patients were older and received their CIED about nine years earlier. Any form of tissue scar and technical problems were much more common in the two groups of patients with major complications. Conclusions: The risk factors for CVWT and TVD are similar, and the most important ones are related to long lead dwell time and its consequences for the heart (various forms of fibrotic scarring). The occurrence of procedural complications does not affect long-term survival in patients undergoing lead extraction.

Keywords: transvenous lead extraction; lead extraction-related major complications; cardiac/vascular wall tear; worsening tricuspid regurgitation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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