Thorac Cardiovasc Surg 2019; 67(S 01): S1-S100
DOI: 10.1055/s-0039-1678947
Short Presentations
Sunday, February 17, 2019
DGTHG: Auf den Punkt gebracht - Arrhythmie/Coronary
Georg Thieme Verlag KG Stuttgart · New York

Up to 5-Year Follow-up after Transvenous Lead Extraction Procedures

L. Castro
1   Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
S. Pecha
1   Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
S. Amin
1   Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
M. Linder
2   Klinik für Allgemeine und Interventionelle Kardiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
N. Gosau
3   Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
S. Willems
3   Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
H. Reichenspurner
1   Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
,
S. Hakmi
1   Klinik für Herzchirurgie, Universitäres Herzzentrum Hamburg, Hamburg, Germany
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Publikationsdatum:
28. Januar 2019 (online)

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Objectives: Only little data exist on long-term outcomes following transvenous lead extraction (TLE) of pacing and implantable cardioverter defibrillator (ICD) leads. Here, we present a long-term follow-up of a large cohort of patients who underwent TLE for infectious and noninfectious indications at our high volume lead extraction center.

Methods: We conducted a follow-up study on 177 consecutive patients, who underwent TLE using different extraction tools at our university center between July 2013 and June 2018. Indications for lead extraction were infections in 67.2%, lead malfunctions in 20.3% and other indications in 12.5%. Survival, outcomes and complications were classified in accordance with the 2009 Heart Rhythm Society consensus statement on TLE.

Results: Mean patients age was 65.2 ± 14.8 years and 48 (27.1%) patients were female. 44 (24.9%) patients had a prior cardiac surgery, 48 (27.1%) showed highly reduced ejection fraction and 42 (23.7%) were suffering from chronic kidney injury. A total of 381 (70.3% pacing and 29.7% ICD) leads were treated. Mean dwell time of the oldest extracted lead was 91.2 ± 69.6 months. Complete procedural or clinical success was achieved in 167 (94.4%) cases. Major procedure related complications occurred in 1.7% without any periprocedural death. Ten patients (5.6%) died in-hospital due to sepsis correlated complications or cardiac decompensation. The mean post-discharge follow-up time was 28.3 ± 18.1 months, showing a survival rate of 92.8%. The mean time to death during the follow-up period was 23.7 ± 18.4 months. None of these 12 patients died due to the TLE or device therapy. The presence of major procedural related complications was not associated with in-hospital or long-term mortality.

Conclusions: Follow-up data after TLE showed a low rate of periprocedural complications. Main causes for in-hospital mortality were sepsis or cardiac decompensation after device removal. Long-term follow-up showed a good survival rate of 92.8% despite this morbid patient cohort.