A (b)(6) female presents for extraction of a fractured cardiac icd lead from the right ventricle, indwell time was 132 months.The lead was prepped with a spectranetics lead locking device, a 14 fr.Spectranetics glidelight laser sheath was used to free up the lead to the midway point of the proximal icd coil, then progress stalled.The device was upsized to a 16 fr.Spectranetics glidelight laser sheath which moved easily over the proximal coil and the lead came free.The 16 fr.Glidelight never traveled past the svc/ra junction.After extraction of the lead, the patient experienced a drop in blood pressure.Tee verified an effusion; the surgeon was called in and intervention was initiated.A tear was identified at the rv apex.The defect was repaired and the patient survived the procedure.This report is being made against the lead locking device as the potential mechanism of injury.
|