A philips representative reported that a cardiac lead management procedure commenced to extract five leads due to infection.The surgical access point was the right subclavian.Lead locking device (lld) was inserted for traction in all leads.Left ventricular (lv) lead was removed without issue.Spectranetics glidelight laser sheath was utilized to remove the icd lead, but met resistance in superior vena cava (svc).Physician switched to the ra lead which was removed without issue.The icd lead was removed with cook medical's evolution 11fr.Patient's blood pressure was 120/60 after ra lead was removed.After a few minutes the blood pressure began to steadily drop and cardiac tamponade was detected.Rescue efforts commenced including sternotomy.A right atrial perforation was detected and successfully repaired.The adverse event occurred while using cook evolution 11fr.However, since the spectranetics lead locking device was used as the traction platform this mdr is being filed.
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