Hybrid minimally invasive technique with the bidirectional rotational Evolution mechanical sheath for transvenous lead extraction: A collaboration between electrophysiologists and cardiac surgeons.

We report a case of a 63-year-old man referred for lead extraction with the bidirectional rotational Evolution RL mechanical sheath because of systemic infection. As it was judged a "high-risk" procedure, we opted for a "hybrid," minimally invasive approach consisting in a minithoracotomic access. This technique is a feasible approach, and it might be a potential safer alternative in the most challenging transvenous lead extraction procedures.