Clinical utility of routine use of continuous transesophageal echocardiography monitoring during transvenous lead extraction procedure.

Détails

ID Serval
serval:BIB_10D5DBCE8303
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical utility of routine use of continuous transesophageal echocardiography monitoring during transvenous lead extraction procedure.
Périodique
Heart rhythm
Auteur(s)
Regoli F., Caputo M., Conte G., Faletra F.F., Moccetti T., Pasotti E., Cassina T., Casso G., Schlotterbeck H., Engeler A., Auricchio A.
ISSN
1556-3871 (Electronic)
ISSN-L
1547-5271
Statut éditorial
Publié
Date de publication
02/2015
Peer-reviewed
Oui
Volume
12
Numéro
2
Pages
313-320
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Data on the use of transesophageal echocardiography (TEE) during transvenous lead extraction (TLE) procedures are scarce.
The purpose of this study was to assess the routine use of TEE during transvenous lead extraction.
From January 2009 to January 2014, TLE of 241 leads in 168 patients (mean age 70 ± 13 years, 129 male, left ventricular ejection fraction 37% ± 13%) was performed. Indication for TLE was lead dysfunction (56.5%), upgrade (27.0%), infection (13%), or other (3.1%). TLE techniques combined a mechanical approach amended by laser technique if required. Extraction procedures were performed with patients under general anesthesia with continuous invasive arterial blood pressure and TEE monitoring.
TEE was possible in all except 1 patient. TEE images in different projections were acquired and stored before and immediately after extraction of each lead. TLE was complete for 236 of 241 leads (97.9%); 4 distal lead tips (1.7%) remained in situ, and 1 dual-coil implantable cardioverter-defibrillator electrode (0.4%) could not be removed. New TEE findings after TLE were observed in 7 of 161 cases (4.3%): pericardial effusion (mild in 4 [2.5%] and severe in 1 [0.6%]) and worsening of tricuspid valve insufficiency (2 patients [1.2%]). The only case of severe pericardial effusion occurred after laceration of the superior vena cava, which required immediate rescue surgery (0.6%, confidence interval 0.01-3.3). In all other cases, TEE findings did not entail immediate diagnostic or therapeutic measures.
New TEE findings produced during TLE necessitating immediate therapeutic measures occurred in only 0.6% of cases, suggesting the limited utility of routine continuous TEE monitoring during TLE.

Mots-clé
Aged, Catheterization, Central Venous/methods, Defibrillators, Implantable, Device Removal/methods, Echocardiography, Transesophageal, Equipment Failure, Female, Heart Failure/therapy, Humans, Male, Monitoring, Intraoperative/methods, Retrospective Studies, Treatment Outcome, Vena Cava, Superior, Cardiac implantable device, Lead extraction procedure, Lead management, Transesophageal echocardiography monitoring, Transvenous lead extraction
Pubmed
Web of science
Création de la notice
31/08/2017 14:40
Dernière modification de la notice
20/08/2019 13:38
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