Key result
Percutaneous extraction using rotational sheaths successfully removes a misplaced ventricular lead after 12 years.
Why the study?
Lead removal was required after 12 years due to mitral valve regurgitation caused by retraction of the posterior leaflet by an inadvertently misplaced lead.
Case Report (n=1)
Percutaneous lead extraction using rotational dilating sheaths is a feasible option for removing chronically misplaced leads via an atrial septal defect, potentially avoiding high-risk open surgery.
May offer nonsurgical option for chronic misplaced leads; single case leaves open need for larger validation.
Background Necessity for lead removal in this case was after 12 years due to mitral valve regurgitation caused by retraction of the posterior leaflet by the inadvertently misplaced lead. Case Description This history describes a 45-year-old woman with history of multiple cardiac operations at young age with an abandoned defibrillator lead via a patent atrial septal defect. Lead extraction was performed with first described use of rotational dilating sheaths to reduce emboli risk, hoping to avoid a fourth surgical procedure with high risk. Conclusions Percutaneous lead removal using rotational sheaths is possible even for misplaced leads after long-time intervals with acceptable operative risk.
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Easo et al. (2019) conducted a case report in Misplaced ventricular lead via an atrial septal defect causing mitral valve regurgitation (n=1). Percutaneous lead extraction using rotational dilating sheaths was evaluated on Lead removal success and operative risk. Percutaneous lead removal using rotational sheaths was successfully performed for a misplaced ventricular lead after 12 years with acceptable operative risk.
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