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- Title
Analysis of a 10-year period of lead removal in a referral centre.
- Authors
Marinheiro, Rita; Neves, José Pedro; Morgado, Francisco; Madeira, Márcio; Magro, Pedro; Carmo, Pedro; Adragão, Pedro
- Abstract
Open in new tab Download slide Open in new tab Download slide OBJECTIVES Our goal was to analyse all lead extraction procedures (transvenous or open surgery) performed in our centre and the short- and long-term follow-up data from these patients. METHODS All lead extractions performed from 2008 to 2017 were retrospectively reviewed for patient characteristics and indications for device implantation; indications for lead extraction; techniques used; peri- and postprocedural complications and short- and long-term follow-up data. RESULTS A total of 159 patients (282 leads) were included [age 70 (62–78) years; 72% men]. The median follow-up time was 57 (25–90) months. Patients with lead explants were excluded. The most common indication for lead removal was infection (77%). A surgical approach was necessary in 14 patients (9%) owing to unsuccessful transvenous removal (n = 3), large vegetation in the lead (n = 4), concomitant valvular endocarditis (n = 2), other indications for open surgery (n = 4) and complicated transvenous removal (n = 1). Removal was tried for 282 leads. Of those, 256 were completely removed. Clinical success was achieved in 155 individual patients (98%). Complications occurred in 6 patients: 3 persistent infections, 1 stroke and 2 blood vessel ruptures. The procedure-related mortality rate was 2% (n = 3). CONCLUSIONS Lead removal was associated with a high success rate and low all-cause complication and mortality rates. Emergency surgery because of acute complications was rare, and open-heart surgery was most frequently elective and not associated with a worse outcome.
- Publication
Interactive Cardiovascular & Thoracic Surgery, 2020, Vol 31, Issue 2, p166
- ISSN
1569-9293
- Publication type
Article
- DOI
10.1093/icvts/ivaa078