Percutaneous removal of transvenous pacemaker leads using an extraction device

Singh, Navreet; Langer, Vijay; Chadha, D.S.; Ak, Ghosh; Sengupta, Sanjeev; Gupta, Ravneesh; Dugal, Jaskaran Singh

doi:10.1016/j.mjafi.2012.06.007

Cited by 4 publications

(1 citation statement)

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“…Percutaneous lead extraction is the preferred initial approach. Late lead extraction in CIED endocarditis can be challenging especially due to fibrotic adhesions that develop over time and increase the risk of complications: tricuspid valve injury, cardiac tamponade, subclavian vein laceration, hemothorax, massive hemorrhage, lead fracture, or septic embolic phenomena [ 6 , 7 ]. Procedures done in centers with experience are associated with significantly lower major all-cause in-hospital complications and death, which is why this type of high-risk patient should be referred to high-volume hospitals.…”

Section: Introductionmentioning

confidence: 99%

A Rare Entity–Percutaneous Lead Extraction in a Very Late Onset Pacemaker Endocarditis: Case Report and Review of Literature

et al. 2021

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The number of infections related to cardiac implantable electronic devices (CIEDs) has increased as the number of devices implanted around the world has grown exponentially in recent years. CIED complications can sometimes be difficult to diagnose and manage, as in the case of lead-related infective endocarditis. We present the case of a 48-year-old male diagnosed with Staphylococcus aureus device-related infective endocarditis, 12 years after the implant of a single chamber pacemaker. A recent history of the patient includes two urinary catheterizations due to obstructive uropathy in the context of a prostatic adenoma, 2 months previously, both without antibiotic prophylaxis; no other possible entry sites were found and no history of other invasive procedures. After initiation of antibiotic therapy according to antibiotic susceptibility testing, we decided to remove the right ventricular passive fixation lead along with the vegetation and pacemaker generator; because of severe lead adhesions in the costoclavicular region, and especially in the right ventricle, we needed mechanical sheaths to remove the abundant fibrous tissue that encompassed the lead. After a difficult, but successful, lead extraction along with a large vegetation and 6 weeks’ antibiotic therapy, the clinical and biological evolution was favorable, without reappearance of symptoms. While very late lead endocarditis is a rarity, late lead-related infective endocarditis (more than 12 months elapsed since implant) is not an exception; this is why we find that endocarditis prophylaxis should be reconsidered in certain patient categories, our patient being proof that procedures with neglectable endocarditis risk according to the guidelines can lead to bacterial endocarditis.

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Section: Introductionmentioning

confidence: 99%