The German Laser Lead Extraction Registry: GALLERY

S. Pecha; H. Burger; V. Möller; T. Madej; B. Osswald; A. Maali; R. De Simone; N. Monsefi; V. Ziaukas; S. Erler; H. Elfarra; M. Perthel; W. Hemmer; N. Ghaffari; T. Sandhaus; H. Busk; J. Schmitto; V. Bärsch; J. Easo; H. Treede; M. Albert; H. Nägele; D. Zenker; Y. Hegazy; D. Ahmadi; W. Ehrlich; M. Knaut; H. Reichenspurner; C. Butter; S. Hakmi

doi:10.1055/s-0039-1678794

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2019; 67(S 01): S1-S100
DOI: 10.1055/s-0039-1678794

Oral Presentations

Sunday, February 17, 2019

DGTHG: Arrhythmie/Sondenextraktion/Schrittmachertherapie

Georg Thieme Verlag KG Stuttgart · New York

The German Laser Lead Extraction Registry: GALLERY

S. Pecha

¹Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany

,

H. Burger

²Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany

,

V. Möller

³Herzzentrum Brandenburg, Kardiologie, Bernau bei Berlin, Germany

,

T. Madej

⁴Herzzentrum Dresden, Klinik für Herzchirurgie, Dresden, Germany

,

B. Osswald

⁵Universitätsklinikum Düsseldorf, Klinik für Kardiovaskuläre Chirurgie, Düsseldorf, Germany

,

A. Maali

⁶Herzzentrum Coswig, Herz- und Gefäßchirurgie, Coswig, Germany

,

R. De Simone

⁷Universitätsklinikum Heidelberg, Klinik für Herzchirurgie, Heidelberg, Germany

,

N. Monsefi

⁸Universitätsklinikum Frankfurt, Thorax-, Herz- und Thorakale Gefäßchirurgie, Frankfurt am Main, Germany

,

V. Ziaukas

⁹Schüchtermann-Klinik, Herzchirurgie, Bad Othenfelde, Germany

,

S. Erler

¹⁰Herz- und Gefässzentrum, Klinik für Herz-Thorax-Chirurgie, Bad Bevensen, Germany

,

H. Elfarra

¹¹Universitätsklinikum Marburg, Herz- und Thorakale Gefäßchirurgie, Marburg, Germany

,

M. Perthel

¹²Herzzentrum Bad Segeberg, Herzchirurgie, Bad Segeberg, Germany

,

W. Hemmer

¹³Sana Herzchirurgie Stuttgart, Hemmer, Stuttgart, Germany

,

N. Ghaffari

¹⁴Helios Klinik für Herzchirurgie Karlsruhe, Herzchirurgie, Karlsruhe, Germany

,

T. Sandhaus

¹⁵Universitätsklinikum Jena, Klinik für Herz- und Thoraxchirurgie, Jena, Germany

,

H. Busk

¹⁶Universitätsklinikum Magdeburg, Herz- und Thoraxchirurgie, Magdeburg, Germany

,

J. Schmitto

¹⁷Medizinische Hochschule Hannover, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Hannover, Germany

,

V. Bärsch

¹⁸Helios Klinikum Siegburg, Herzchirurgie und Thoraxchirurgie, Siegburg, Germany

,

J. Easo

¹⁹Klinikum Oldenburg, Universitätsklinik für Herzchirurgie, Oldenburg, Germany

,

H. Treede

²⁰Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Herzchirurgie, Halle (Saale), Germany

,

M. Albert

²¹Robert-Bosch-Krankenhaus, Herz- und Gefäßchirurgie, Stuttgart, Germany

,

H. Nägele

²²Albertinen Herz- und Gefäßzentrum, Herzinsuffizienz- und Devicetherapie, Hamburg, Germany

,

D. Zenker

²³Universitätsmedizin Göttingen, Klinik für Thorax-, Herz- und Gefäßchirurgie, Göttingen, Germany

,

Y. Hegazy

²⁴Herzzentrum Lahr, Herz-, Thorax- und Gefäßchirurgie, Lahr, Germany

,

D. Ahmadi

¹Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany

,

W. Ehrlich

²Kerckhoff-Klinik, Herzchirurgie, Bad Nauheim, Germany

,

M. Knaut

⁴Herzzentrum Dresden, Klinik für Herzchirurgie, Dresden, Germany

,

H. Reichenspurner

¹Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany

,

C. Butter

³Herzzentrum Brandenburg, Kardiologie, Bernau bei Berlin, Germany

,

S. Hakmi

¹Universitäres Herzzentrum Hamburg, Klinik und Poliklinik für Herz- und Gefäßchirurgie, Hamburg, Germany

› Author Affiliations

Abstract

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Objectives: The German Laser Lead Extraction Registry (GALLERY) is a retrospective, national multicenter registry, investigating the safety and efficacy of laser lead extraction procedures in Germany.

Methods: Twenty-four German centers performing laser lead extraction were participating in the registry. All patients, treated with a laser lead extraction procedure between January 2013 and March 2017, were consecutively enrolled. The primary end point of the study was the lead extraction–related safety, determined by major procedure-related complications. Secondary end point was the complete procedural success rate.

Results: A total of 2,533 consecutive patients with 6,123 leads were included in the registry; 5,515 leads were treated. Mean dwell time was 109.05 ± 71.46 months. Mean number of leads per patient was 2.41 ± 1.02. Out of 5,515, 3,984 were pacing leads and 1,531 were ICD leads. Indications for lead extraction were local infection (35.33%), systemic infection (28.50%), lead dysfunction (30.68%), or other indications (5.49%).

The primary end point of major procedure-related complications occurred in 2.05% of patients. The procedure-related mortality was 0.55%. Complete procedural success rate was 97.79%. Additional mechanical extraction tools or snares were successfully used in 4.42% of the cases. Despite the use of additional tools, the procedural failure rate was 2.21%. The in-hospital mortality was 3.55%, with significantly higher mortality rate in patients with systemic infection, compared with patients with local infection or noninfectious indications for lead extraction (11.08 vs. 0.55%, p < 0.0001).

Conclusion: In the GALLERY, a low procedure-related mortality and high success rate of complete lead extraction have been demonstrated. However, the presence of systemic infection significantly contributes to increase in-hospital mortality, despite successful lead extraction.