A lead extraction procedure commenced to remove two right ventricular (rv) leads due to non function.A right atrial (ra) lead was present within the patient but was not targeted for extraction.Spectranetics lead locking devices (lld ez) were inserted into each of the rv leads to provide traction platforms to aid in lead extraction.The physician began the procedure by using a spectranetics tightrail sub-c rotating dilator sheath, but was not able to advance the tightrail sub-c device in the clavicular region.Next, the physician chose a 16f glidelight laser sheath.Shortly after the 16f glidelight device was in use, the patient's blood pressure dropped.Rescue efforts began immediately, including a rescue balloon and a right window made into the chest with a chest tube placed to drain blood.A thoracotomy was then performed, with a tear in the innominate vein identified.Repair of the tear was successful.However, more innominate tears were identified as well.Repairs were completed successfully and the patient survived the procedure (please reference mdr 1721279-2021-00012 which captures the innominate injuries which occurred while the glidelight device was in use).Neither rv lead was removed; these leads, along with the lld's inside, were cut and capped and remained within the patient.The physician did not attempt to unlock the lld's within the two rv leads prior to cutting and capping them.This report captures the lld which was present within rv lead model 6947, which was cut and capped and remained in the patient.Mdr 1721279-2021-00013 captures the lld which was present within rv lead model 4068, and was also cut and capped and remained in the patient.
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