Chylothorax After Single-Chamber Implantable Cardioverter-Defibrillator Extraction.

BACKGROUND

Cardiac implantable electrical device (CIED) lead extraction is increasingly common, with up to 15,000 cases annually. Although the procedure is generally safe, complications can occur, and knowledge of potential issues is essential for patient care.

CASE SUMMARY

A 63-year-old man with multiple comorbidities underwent implantable cardioverter-defibrillator lead extraction as a result of device pocket infection. Post-procedure, he developed worsening hypoxic respiratory failure. Imaging revealed a new right-sided pleural effusion, which on drainage was confirmed as chylothorax. Despite initial improvement with conservative management, the patient's condition deteriorated, leading to cardiac arrest and eventual death.

DISCUSSION

This case presents the first reported instance of chylothorax complicating CIED lead extraction. It highlights the importance of considering rare complications in postprocedural care, especially in patients with complex medical histories.

TAKE-HOME MESSAGES: Chylothorax should be considered in patients with new pleural effusions following CIED lead extraction. Early recognition and appropriate management of rare complications are crucial in high-risk patients.