Chapter 7 124 Table 3 Detailed overview of procedural failures Pt. Age/sex Indication TLE Implanted device Details 1 36/F VCS syndrome Biventricular ICD, abandoned ICD lead Disruption and breakage of abandoned St. Jude Medical Riata 1582 ICD lead (10 years in situ) just proximal to distal coil during indirect traction with snare. Successful SVC stenting. 2 41/M Upgrade to biventricular ICD Dual-chamber PM Wedging and breakage of distal part of Biotronik Solia S ProMRI ventricular lead (2 years in situ) at proximal binding site in subclavian vein during direct traction. No attempt with mechanical sheath as new leads were already in situ. 3 43/M ICD and LV lead malfunction Biventricular ICD Disruption and breakage of Biotronik Linox Smart S65 ICD lead (5 years in situ) just proximal to distal coil during indirect traction with snare. 4 49/F Fracture of ICD lead Dual-chamber ICD Disruption and breakage of Medtronic Sprint Fidelis 6949 ICD lead (10 years in situ) distal to proximal coil during indirect traction with snare (after superior approach with powered mechanical heath failed). 5 62/M Lead-related endocarditis (S. epidermidis) Dual-chamber PM Disruption and breakage of tip (< 1 cm) of atrial lead during countertraction with powered mechanical sheath. Complicated by left-sided ischemic stroke the following day with permanent disability (modified Rankin score 3). Most likely due to paradoxical embolus as the patient was known with patent foramen ovale. 6 70/M Atrial and LV lead malfunction Biventricular ICD Wedging of distal part of Biotronik Setrox S53 atrial lead in subclavian vein. Powered mechanical sheath caused excessive bleeding at venous entry site requiring surgical repair, decided to leave remnant lead in place. ICD implantable cardioverter-defibrillator, PM pacemaker, SVC superior vena cava, TLE transvenous lead extraction
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