A Study of Major and Minor Complications of 1500 Transvenous Lead Extraction Procedures Performed with Optimal Safety at Two High-Volume Referral Centers

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, 25-317 Kielce, Poland
Wojciech Jacheć: 2nd Department of Cardiology, Silesian Medical University, 41-808 Zabrze, Poland
Dorota Nowosielecka: Department of Cardiac Surgery, 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 Cardiac Surgery, 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 Cardiology, Masovian Specialist Hospital of Radom, 26-617 Radom, Poland
Maciej Polewczyk: Department of Microbiology, Collegium Medicum, Jan Kochanowski Univeristy, 25-369 Kielce, Poland
Andrzej Kutarski: Department of Cardiology, Medical University, 20-059 Lublin, Poland

IJERPH, 2021, vol. 18, issue 19, 1-13

Abstract: Background: Transvenous lead extraction (TLE) is the preferred management strategy for complications related to cardiac implantable electronic devices. TLE sometimes can cause serious complications. Methods: Outcomes of TLE procedures using non-powered mechanical sheaths were analyzed in 1500 patients (mean age 68.11 years; 39.86% females) admitted to two high-volume centers. Results: Complete procedural success was achieved in 96.13% of patients; clinical success in 98.93%, no periprocedural death occurred. Mean lead dwell time in the study population was 112.1 months. Minor complications developed in 115 (7.65%), major complications in 33 (2.20%) patients. The most frequent minor complications were tricuspid valve damage (TVD) (3.20%) and pericardial effusion that did not necessitate immediate intervention (1.33%). The most common major complication was cardiac laceration/vascular tear (1.40%) followed by an increase in TVD by two or three grades to grade 4 (0.80%). Conclusions: Despite the long implant duration (112.1 months) satisfying results without procedure-related death can be obtained using mechanical tools. Lead remnants or severe tricuspid regurgitation was the principal cause of lack of clinical and procedural success. Worsening TR(Tricuspid regurgitation) (due to its long-term consequences), but not cardiac/vascular wall damage; is still the biggest TLE-related problem; when non-powered mechanical sheaths are used as first-line tools.

Keywords: transvenous lead extraction; minor and major complications; cardiac laceration/vascular tear; epicardial fluid; tricuspid valve damage (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 (5)

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