Department of Cardiac Surgery, Heidelberg University Hospital, INF 420, 69120, Heidelberg, Germany.
J Cardiothorac Surg. 2021 Oct 30;16(1):321. doi: 10.1186/s13019-021-01706-5.
Lead laser extraction is a well-established method for removing unwanted leads with low morbidity and mortality.
In this observational study, we documented our experience with venous occlusion after lead laser extraction.
Retrospective data of patients who underwent lead laser extraction between May 2010 and August 2018 was analyzed. Two subgroups of patients were identified. First group represented patients after lead laser extraction who suffered postoperative venous occlusion. Second group represents patients after lead laser extraction, who has documented patent venous access after lead laser extraction.
219 patients underwent percutaneous laser lead extraction. The mean age of patients was 65 ± 14 years. Of these patients, 74% were male. The Most common indication for extraction was Nonfunctional lead (45.2%, n = 99) followed by pocket infection with 33.8% and endocarditis (17.3%). A total number of 447 leads underwent laser extraction. In 7.8% of the patients, lead extraction was partially successful and lead extraction was not successful in only 2.3% of the patients. Only 13 patients developed a documented venous occlusion postoperatively and 26 patients has documented absence of venous occlusion, of whom 17 were under oral anticoagulation.
Lead laser extraction may lead to venous occlusion, which is mostly asymptomatic but it prevents future lead implantation. The use of oral anticoagulant may prevent postoperative venous occlusion.
铅激光提取是一种成熟的方法，可在低发病率和死亡率的情况下去除不需要的铅。
在这项观察性研究中，我们记录了我们在铅激光提取后静脉闭塞的经验。
回顾性分析了 2010 年 5 月至 2018 年 8 月期间接受铅激光提取的患者的数据。确定了两组患者。第一组代表铅激光提取后发生术后静脉闭塞的患者。第二组代表铅激光提取后，在铅激光提取后记录到有静脉通路的患者。
219 例患者接受了经皮激光引线提取。患者的平均年龄为 65±14 岁。其中 74%为男性。最常见的提取指征是非功能性引线（45.2%，n=99），其次是口袋感染（33.8%）和心内膜炎（17.3%）。总共对 447 个引线进行了激光提取。7.8%的患者部分成功提取了引线，只有 2.3%的患者未成功提取引线。只有 13 例患者术后发生了明确的静脉闭塞，26 例患者记录到静脉闭塞不存在，其中 17 例正在服用口服抗凝剂。
铅激光提取可能导致静脉闭塞，大多数情况下无症状，但它可防止未来的铅植入。使用口服抗凝剂可能预防术后静脉闭塞。
