Open AccessPearls of Wisdom for High-Risk Laser Lead Extractions: A Focused Review
Author(s) -
Lilibeth Fermin,
Ralf E. Gebhard,
Ryan Azarrafiy,
Roger G. Carrillo
Publication year - 2018
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1213/ane.0000000000002540
Subject(s) - medicine , lead (geology) , cardiopulmonary bypass , intensive care medicine , risk analysis (engineering) , surgery , anesthesia , geology , geomorphology
Due to new indications and improved technology, the incidence of laser lead extraction (LLE) has significantly increased over the past years. While LLE has been well studied and proven to be safe and effective, only few studies are geared toward the anesthesiologist's role during high-risk LLEs. This article utilized both a focused review and authors' experience to investigate anesthetic protocols during LLEs. Through this review, we recommend best practices for the anesthesiologist including appropriate procedure location, onsite availability of a cardiac surgeon, availability of a cardiopulmonary bypass machine, and intraoperative use of echocardiography to detect and address potential complications during high-risk LLEs.