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

Author

Listed:
  • 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
    Department of Cardiac Surgery, Świętokrzyskie Cardiology Center, 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)

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.

Suggested Citation

  • Łukasz Tułecki & Anna Polewczyk & Wojciech Jacheć & Dorota Nowosielecka & Konrad Tomków & Paweł Stefańczyk & Jarosław Kosior & Krzysztof Duda & Maciej Polewczyk & Andrzej Kutarski, 2021. "Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage," IJERPH, MDPI, vol. 18(17), pages 1-13, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:9100-:d:624331
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    Citations

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    Cited by:

    1. Andrzej Kutarski & Wojciech Jacheć & Dorota Nowosielecka & Marek Czajkowski & Łukasz Tułecki & Anna Polewczyk, 2022. "Repeat Transvenous Lead Extraction—Predictors, Effectiveness, Complications and Long-Term Prognostic Significance," IJERPH, MDPI, vol. 19(23), pages 1-16, November.
    2. Anna Polewczyk & Wojciech Jacheć & Dorota Nowosielecka & Andrzej Tomaszewski & Wojciech Brzozowski & Dorota Szczęśniak-Stańczyk & Krzysztof Duda & Andrzej Kutarski, 2022. "Tricuspid Valve Damage Related to Transvenous Lead Extraction," IJERPH, MDPI, vol. 19(19), pages 1-16, September.
    3. Paweł Stefańczyk & Dorota Nowosielecka & Anna Polewczyk & Wojciech Jacheć & Andrzej Głowniak & Jarosław Kosior & Andrzej Kutarski, 2022. "Efficacy and Safety of Transvenous Lead Extraction at the Time of Upgrade from Pacemakers to Cardioverter-Defibrillators and Cardiac Resynchronization Therapy," IJERPH, MDPI, vol. 20(1), pages 1-16, December.
    4. Paul-Mihai Boarescu & Iulia Diana Popa & Cătălin Aurelian Trifan & Adela Nicoleta Roşian & Ştefan Horia Roşian, 2022. "Practical Approaches to Transvenous Lead Extraction Procedures—Clinical Case Series," IJERPH, MDPI, vol. 20(1), pages 1-15, December.

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