scholarly journals Active fixation coronary sinus lead extraction – A safe procedure

2016 ◽  
Vol 35 (9) ◽  
pp. 505-506
Author(s):  
Tatiana Guimarães ◽  
Gustavo Lima da Silva ◽  
Ana Bernardes ◽  
João de Sousa ◽  
Pedro Marques
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Safe Procedure ◽  
Active Fixation ◽  
Coronary Sinus Lead

scholarly journals Active fixation coronary sinus lead extraction – A safe procedure

2016 ◽  
Vol 35 (9) ◽  
pp. 505-506
Author(s):  
Tatiana Guimarães ◽  
Gustavo Lima da Silva ◽  
Ana Bernardes ◽  
João de Sousa ◽  
Pedro Marques
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Safe Procedure ◽  
Active Fixation ◽  
Coronary Sinus Lead

Active fixation mechanism complicates coronary sinus lead extraction and limits subsequent reimplantation targets

2012 ◽  
Vol 36 (1) ◽  
pp. 81-86 ◽  
Author(s):  
E. M. Cronin ◽  
C. P. Ingelmo ◽  
J. Rickard ◽  
O. M. Wazni ◽  
D. O. Martin ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Active Fixation ◽  
Coronary Sinus Lead

scholarly journals Ratchet mechanism selectively causing idiopathic macrodislodgement of an active-fixation coronary sinus lead: a case report

2020 ◽  
Author(s):  
Pier Giorgio Golzio ◽  
Arianna Bissolino ◽  
Raffaele Ceci ◽  
Simone Frea
Keyword(s):  
Coronary Sinus ◽  
Pulse Generator ◽  
Thoracic Inlet ◽  
Ratchet Mechanism ◽  
Active Fixation ◽  
First Case ◽  
Time In Literature ◽  
Pacemaker Leads ◽  
Coronary Sinus Lead ◽  
Arm Motion

Abstract Background ‘Idiopathic’ lead macrodislodgement may be due to Twiddler’s syndrome depending on active twisting of pulse generator within subcutaneous pocket. All leads are involved, at any time from implantation, and frequently damaged. In the past few years, a reel syndrome was also observed: retraction of pacemaker leads into pocket without patient manipulation, owing to lead circling the generator. In other cases, a ‘ratchet’ mechanism has been postulated. Reel and ratchet mechanisms require loose anchoring, occur generally briefly after implantation, with non-damaged leads. We report the first case of an active-fixation coronary sinus lead selective macrodislodgement involving such ratchet mechanism. Case summary A 65-year-old man underwent biventricular defibrillator device implantation, with active-fixation coronary sinus lead. Eight months later, he complained of muscle contractions over device pocket. At fluoroscopy, coronary sinus lead was found near to pocket, outside of thoracic inlet. Atrial and ventricular leads were in normal position. After opening pocket, a short tract of coronary sinus lead appeared anteriorly dislocated to generator, while greater length of lead body twisted a reel behind. The distal part of lead was found outside venous entry at careful dissection. Atrial and ventricular leads were firmly anchored. Discussion Our case is a selective ‘Idiopathic’ lead macrodislodgement, possibly due to a ratchet mechanism between the lead and the suture sleeve, induced by normal arm motion; such mechanism incredibly, and for first time in literature involves a coronary sinus active-fixation lead. Conclusion Careful attention should always be paid to secure anchoring even of active-fixation coronary sinus leads.

Coronary Sinus Lead Extraction

2017 ◽  
Vol 13 (1) ◽  
pp. 105-115 ◽  
Author(s):  
Edmond M. Cronin ◽  
Bruce L. Wilkoff
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Coronary Sinus Lead

Large, Single-Center Experience in Transvenous Coronary Sinus Lead Extraction: Procedural Outcomes and Predictors for Mechanical Dilatation

2011 ◽  
Vol 35 (2) ◽  
pp. 215-222 ◽  
Author(s):  
ANDREA DI CORI ◽  
MARIA GRAZIA BONGIORNI ◽  
GIULIO ZUCCHELLI ◽  
LUCA SEGRETI ◽  
STEFANO VIANI ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Single Center ◽  
Single Center Experience ◽  
Coronary Sinus Lead ◽  
Procedural Outcomes

scholarly journals Usefulness of mechanical transvenous dilation and location of areas of adherence in patients undergoing coronary sinus lead extraction

EP Europace ◽  
2007 ◽  
Vol 9 (1) ◽  
pp. 69-73 ◽  
Author(s):  
Maria Grazia Bongiorni ◽  
Giulio Zucchelli ◽  
Ezio Soldati ◽  
Giuseppe Arena ◽  
Gabriele Giannola ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Coronary Sinus Lead

scholarly journals 689 Hybrid transvenous and surgical approach for the extraction of coronary sinus leads: a case series

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Ashraf Ahmed ◽  
Gianmarco Arabia ◽  
Luca Bontempi ◽  
Manuel Cerini ◽  
Francesca Salghetti ◽  
...  
Keyword(s):  
Coronary Sinus ◽  
Case Series ◽  
Proximal Part ◽  
The Other ◽  
Right Atrial ◽  
Lead Extraction ◽  
Cardiac Device ◽  
Surgical Extraction ◽  
Coronary Sinus Lead ◽  
Transvenous Approach

Abstract Aims The rates of cardiac device-related infection have increased substantially over the past years. Transvenous lead extraction is the standard therapy for such cases. In some patients, however, the procedure cannot be completed through the transvenous route alone. A hybrid surgical and transvenous approach may provide the solution in such cases. Methods and results We present three cases who underwent hybird transvenous and surgical extraction for coronary sinus leads due to infection of CRT-D systems. One patient had an Attain Starfix lead implanted in the coronary sinus. The procedures were performed under local anaesthesia with continuous haemodynamic and transthoracic echocardiographic monitoring. We highlight the characteristics of the patients, the features of the devices, the technical difficulties, and the outcomes of the procedures. In all cases, the right atrial and right ventricular leads were extracted through the transvenous route. In one patient, they were extracted using regular stylets and manual traction, while in the other two patients, telescoping dilator sheaths (Cook), Tightrail hand-powered mechanical sheaths (Spectranetics), and/or Glidelight Excimer Laser sheaths (Spectranetics) were used. The coronary sinus lead could not be retrieved due to extensive fibrosis after utilizing locking stylets and mechanical dilator sheaths in all three cases, in addition to rotational mechanical sheaths and laser sheaths in one case, so the patients were referred to surgery. Two patients underwent left mini-thoracotomy and one patient underwent midline sternotomy to extract the remaining CS lead. The target vein was identified and ligated, then the fibrosis around the lead was dissected, this was followed by lead retrieval through the surgical incision. The patient who underwent sternotomy suffered from mediastinitis, which required reoperation and mediastinal lavage. There were no complications in the other two patients. All three patients were reimplanted with a new CRT-D device on the contralateral side after the resolution of infection. Conclusions A hybrid surgical and transvenous approach can be complementary in case the transvenous route alone fails to completely extract the coronary sinus lead. The transvenous approach can be used to free the proximal part of the lead, while the distal adhesions can be removed surgically, preferably though a limited thoracic incision.

Primum atrial septal laceration following coronary sinus lead extraction

2019 ◽  
Vol 21 (6) ◽  
pp. 701-701
Author(s):  
Mariateresa Librera ◽  
Guido Carlomagno ◽  
Claudia Calvanese ◽  
Tommaso Lonobile ◽  
Giuseppe De Martino
Keyword(s):  
Coronary Sinus ◽  
Lead Extraction ◽  
Coronary Sinus Lead
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