It was reported that during a lead extraction procedure to remove 2 cardiac leads (both in rv), an injury occurred.Reportedly, the physician prepped both leads with lld devices and started with a 14fr glidelight device.Significant fibrosis was encountered, so the physician up-sized to a 16fr glidelight.The physician then decided to switch to the other rv lead.The physician was able to move past the lead-on-lead binding and advance the laser to the tip of the lead.No lasing was done at this point, only counter-traction.The active fix lead then came free and was completely removed with the laser sheath.Once both lead and laser sheath were completely out of the body, a drop in blood pressure was noted.A sternotomy was performed and small hole in the rv was successfully repaired.The second lead was then removed and the patient outcome was good.
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