Lead extraction procedure for non-functioning lead in the rv and ra.14fr glidelight was selected fore removal of the rv lead.Lead on lead binding was noted.A tear in the subclavian vein occurred.The ra lead extraction was attempted using a tightrail.The lead became stuck in the tightrail device.Tightrail was rotated and pulled, the distal end of the tightrail exited the insertion site.The physician cut the lead leaving half in the device and half in the patient.Pulling on the rv lead, a tear in the tricuspid valve occurred.It is believed the lead was attached to the papillary muscle, pulling on the lead tore the muscle.Repairs were done at different times.The patient was placed on bypass and underwent a tricuspid valve replacement.The subclavian vein was repaired by ir via femoral approach using a stent graft.During the valve repair, the extractor was placing her finger on the hole in the subclavian to stop bleeding.Postoperative, the patient was placed on a right ventricular assist device.The patient expired in the icu, believed due to poor surgical repair and failure of the right ventricular assist device.This report is for the lead locking device.See reports 1721279-2016-00031 for glidelight & 1721279-2016-00033 for tightrail.
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