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

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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, 25-317 Kielce, Poland
    Department of Cardiac Surgery, Świętokrzyskie Cardiology Center, 25-736 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
    Intensive Care Unit, Świętokrzyskie Cardiology Center, 25-736 Kielce, Poland)

  • Andrzej Kutarski

    (Department of Cardiology, Medical University, 20-059 Lublin, Poland)

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.

Suggested Citation

  • Łukasz Tułecki & Anna Polewczyk & Wojciech Jacheć & Dorota Nowosielecka & Konrad Tomków & Paweł Stefańczyk & Jarosław Kosior & Krzysztof Duda & Maciej Polewczyk & Andrzej Kutarski, 2021. "A Study of Major and Minor Complications of 1500 Transvenous Lead Extraction Procedures Performed with Optimal Safety at Two High-Volume Referral Centers," IJERPH, MDPI, vol. 18(19), pages 1-13, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10416-:d:649356
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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.
    5. Paweł Stefańczyk & Dorota Nowosielecka & Anna Polewczyk & Łukasz Tułecki & Konrad Tomków & Wojciech Jacheć & Ewa Lewicka & Andrzej Tomaszewski & Andrzej Kutarski, 2022. "Safety and Effectiveness of Transvenous Lead Extraction in Patients with Infected Cardiac Resynchronization Therapy Devices; Is It More Risky than Extraction of Other Systems?," IJERPH, MDPI, vol. 19(10), pages 1-13, May.

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