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Journal article
A Case of Arterial and Venous Tear during Single Lead Extraction
Case reports in cardiology, v 2016, pp 3836754-3
01 Jan 2016
PMID: 27195154
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Transcutaneous lead extraction can be associated with significant morbidity and mortality. The risk of causing concomitant arterial and venous injury is rare. We report a case of marginal artery rupture with coronary sinus rupture after a CS lead extraction. A 71-year-old male was admitted for extraction of a 6-year-old implantable cardioverter-defibrillator lead due to fracture from insulation break. During the lead extraction, blood pressure fell precipitously and echocardiographic findings were consistent with pericardial effusion. After unsuccessful pericardiocentesis, open chest sternotomy and evacuation of hematoma was performed. Subsequent surgical repair of several injuries was completed including the distal coronary sinus, a large degloving injury of posterior portion of the heart, and first obtuse marginal branch bleed. This case demonstrates that when performing transcutaneous lead extraction (TLE) with laser sheath, a degloving injury can cause arterial rupture with concomitant coronary sinus injury. A multidisciplinary team-based approach can ensure patient safety. Learning Objective. Implantable cardioverter-defibrillator leads will falter over time. With the advancement of new technology for extraction more frequent and serious complications will occur. Active fixation CS leads present unique challenges. In the presence of hemodynamic changes during extraction the occurrence of both an arterial and venous injury must be considered.
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Details
- Title
- A Case of Arterial and Venous Tear during Single Lead Extraction
- Creators
- Michael S. Green - Hahnemann University HospitalDaniel Wu - Hahnemann University HospitalVishal Patel - Hahnemann University HospitalRayhan Tariq - Hahnemann University Hospital
- Publication Details
- Case reports in cardiology, v 2016, pp 3836754-3
- Publisher
- Hindawi Publishing Group
- Number of pages
- 3
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:000375261000001
- Other Identifier
- 991019168679904721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems