Author + information
- Nikhil Patel,
- Malcolm McDonald,
- Natalie Bradford,
- Justin Smith and
- Sean Whalen
Background: The rates of infection associated with implantable cardiac defibrillators (ICDs) and permanent pacemakers (PPMs) continues to rise. Patients with lead vegetations larger than 2 cm are often referred for surgical removal via sternotomy or thoracotomy due to concern for septic pulmonary emoboli. These same patients are often not stable enough for surgical removal.
Methods: AngioVac debridement of vegetations as concomitant or bridging therapy prior to percutaneous laser lead extraction was accomplished at Wake Forest Baptist Medical Center in 3 patients by a team of interventional cardiologists and clinical electrophysiologists. All 3 patients were turned down for surgical extraction.
Results: This study included 2 males and 1 female with an average age of 47 years old. The size of vegetation removed from leads prior to explantation ranged from 2.0-3.9 cm in largest dimension, and the average diameter was 3.03 (0.96) cm. All vegetations were successfully de-bulked in all 3 patients and percutaneous system extraction was performed without complication or need for thoracotomy or sternotomy.
Discussion: Our findings support the use of AngioVac system to facilitate lead extraction with massive vegetations as a safe and effective alternative to thoracotomy or sternotomy.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmias and Clinical EP: Devices 2
Abstract Category: 5. Arrhythmias and Clinical EP: Devices
Presentation Number: 1149-077
- 2017 American College of Cardiology Foundation