Department of Cardiac Surgery, Heidelberg University Hospital, Heidelberg, Germany.
PLoS One. 2023 Oct 20;18(10):e0284802. doi: 10.1371/journal.pone.0284802. eCollection 2023.
Transvenous laser lead extraction (TLE) for cardiac implantable electric devices (CIED) is a challenging procedure especially if performed in octogenarians. In this study we evaluated the safety and efficacy of transvenous laser lead extraction in elderly patients.
This is a retrospective study of octogenarian patients who underwent laser-assisted lead extraction (LLE) (GlideLight laser sheath, Philips, San Diego, USA). 270 Consecutive patients were included. Patients were divided into two groups. Octogenarian group and non-octogenarian group. The Data was gathered from patients treated between September 2013 and January 2020 and is retrospectively analyzed.
Of 270 consecutive patients, 38 (14.0%) were 80 years old or more. The total number of the extracted leads was 556 among which 84(15.0%) from the Octogenarian group. From these leads were 155 single coil leads, 82 dual coil leads, 129 right ventricular pacing leads, 155 right atrial leads, and 35 left ventricular leads. In the Octogenarian group the number of removed leads was as follows: 13 single coil leads, 10 dual coil leads, 28 right ventricular pacing leads, 28 right atrial leads and 5 left ventricular leads. No mortality was recorded in the Octogenarian group. One patient in the YG suffered from a superior vena cava tear and one patient suffered from pulmonary embolism.
In octogenarian laser assisted lead extraction patients is a safe and effective procedure. No increase in morbidity, mortality or perioperative complication could be recorded in this group. Age should not be a limiting factor to perform this procedure.
经静脉激光导线拔除术（TLE）用于心脏植入式电子设备（CIED）是一项具有挑战性的手术，尤其是对于 80 岁以上的患者。本研究旨在评估在老年患者中行经静脉激光导线拔除术（LLE）的安全性和有效性。
这是一项回顾性研究，纳入了行激光辅助导线拔除术（LLE）（GlideLight 激光鞘，Philips，圣地亚哥，美国）的 80 岁以上患者。共纳入 270 例连续患者。患者分为两组：80 岁以上组和非 80 岁以上组。数据采集自 2013 年 9 月至 2020 年 1 月期间接受治疗的患者，并进行回顾性分析。
在 270 例连续患者中，38 例（14.0%）年龄在 80 岁或以上。共拔除 556 根导线，其中 84 根（15.0%）来自 80 岁以上组。这些导线中，155 根为单线圈导线，82 根为双线圈导线，129 根为右心室起搏导线，155 根为右心房导线，35 根为左心室导线。在 80 岁以上组中，拔除的导线数量如下：13 根单线圈导线，10 根双线圈导线，28 根右心室起搏导线，28 根右心房导线和 5 根左心室导线。80 岁以上组无死亡病例。1 例 YG 患者发生上腔静脉撕裂，1 例患者发生肺栓塞。
在 80 岁以上患者中行激光辅助导线拔除术是一种安全有效的方法。该组患者无发病率、死亡率或围手术期并发症增加。年龄不应成为行此手术的限制因素。
