Excimer laser extraction of defibrillator leads can cause LIMA bypass perforation leading to an arterio-venous fistula and STEMI.
May warrant caution with laser extraction in LIMA patients; single case leaves open incidence and prevention strategies.
We describe a case of a so far unknown complication after failed extraction of defibrillator leads. Perforation of the LIMA bypass caused by Excimer laser created an arterio-venous fistula from the proximal bypass to the superior subclavian vein and occlusion of the distal LIMA bypass with consecutive anterior ST-elevation myocardial infarction.
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Christophe Wyss (2012) studied this question.
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