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Successful Laser‐Assisted Removal of an Infected ICD Lead with a Large Vegetation
Author(s) -
CALTON RAJNEESH,
CAMERON DOULAS,
CUSIMANO ROBERT J.,
MERCHANT NAEEM,
CHAUHAN VIJAY
Publication year - 2006
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2006.00459.x
Subject(s) - medicine , vegetation (pathology) , lead (geology) , pathology , geology , geomorphology
Infective endocarditis involving transvenous pacing leads is an uncommon but potentially lethal complication of implantable cardioverter‐defibrillator (ICD) implantation. Complete removal of the device and the leads is presently considered to be the optimal treatment in such patients and laser‐assisted lead removal is an effective and safe nonthoracotomy approach. However, large vegetations (>10 mm) attached to the lead limit nonthoracotomy explantation because of the potential for hemodynamically embarrassing pulmonary embolization. Laser extraction of leads with vegetation area >300 mm 2 has rarely been reported. In this case report, we describe a patient with an infected ICD lead with vegetation greater than 41 × 12.5 mm (512 mm 2 ) in size that was explanted with laser‐assistance. The resulting pulmonary embolus produced a 33 × 20 mm pulmonary infarction without hemodynamic or respiratory compromise.