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Transvenous lead extraction in patients with persistent left superior vena cava
Author(s) -
Curnis Antonio,
Aboelhassan Mohamed,
Cerini Manuel,
Salghetti Francesca,
Fabbricatore Davide,
Maiolo Vincenzo,
Arabia Gianmarco,
Giacopelli Daniele,
Fouad Doaa A.,
Bontempi Luca
Publication year - 2021
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.15021
Subject(s) - persistent left superior vena cava , medicine , stylet , fluoroscopy , fixation (population genetics) , infective endocarditis , lead (geology) , coronary sinus , radiology , endocarditis , cardiology , surgery , population , environmental health , geomorphology , geology
Purpose Predictors of difficulty and complications of transvenous lead extraction (TLE) have been investigated in several studies; however, little is known about the venous anatomical characteristics that can have an impact on procedural outcomes. Among them, the persistent left superior vena cava (PLSVC) is a common anomaly often discovered incidentally during cardiac device implantation and could raise concerns if TLE is indicated. We report technical considerations and outcomes of TLE for two patients with leads implanted via PLSVC. Methods and Results Two cardiac implantable electronic device recipients with isolated PLSVC required TLE due to infective endocarditis in one case and lead failure in the other. In the first case, TLE procedure was performed in a hybrid operating room with minimally invasive video‐assisted thoracoscopic monitoring due to the high procedural risk. Two active fixation 20‐year‐old pacing leads were removed with a relatively short fluoroscopy time. In the second case, we successfully extracted a single‐coil active fixation lead without the need of a locking stylet or advanced extraction tools. There were no procedural complications or adverse events at 1‐year follow‐up. Conclusion TLE procedures for two patients with isolated PLSVC were successfully completed with less difficulty and tools than expected based on the characteristics of the targeted leads. If indicated, TLE in the presence of a PLSVC should be considered in experienced centers.