RESUMO
Objective: To explore the safety and efficacy of a novel lead locking device (LLD) in the procedure of cardiac lead extraction for heart rhythm implants. Methods: A total of 6 patients using LLD for cardiac lead extraction in our hospital were retrospectively reviewed. Clinical parameters, the reason of cardiac lead extraction, lead locking stylet condition, outcome of lead extraction and operative complications were summarized. Results: There were 6 patients including 1 female with the median age at 62.5 years. LLD was used and 13 cardiac leads were extracted including 1 scrap electrode wire and 12 functional electrode wire. Among those, LLD was successfully inserted and locked on the top of 11/13 (85%) leads for whole procedure and 2 (15%) leads were not locked for whole procedure; 12 (92 %) leads were completely removed and 1 (8%) lead was partially removed. No severe complications occurred. Conclusion: The novel LLD may safely and effectively extract electrode lead which is beneficial for complete cardiac lead extraction.
RESUMO
A 56-year-old male had complained of serious facial edema 2 years after transvenous pacemaker implantation. Venography at admission showed complete occlusion of the left innominate vein and severe stenosis of the SVC. A 20mmHg pressure gradient was recognized between bilateral internal jugular veins and SVC. Various conservative therapeutic approaches had been ineffective, then surgical treatment was recommended. A median sternotomy was made, removing the pacing lead by a Locking Stylet easily and safely. The stenotic section was dilated, resecting the fibrous tissue in the thickened venous wall, and enlarged with a shaped pericardial patch. Symptoms diminished postoperatively. Histological findings revealed phlebosclerosis of the stenotic venous wall. This type of surgical approach is effective for lesions with irreversible occlusion or severe stenosis causing SVC syndrome and which do not respond to conservative therapy.