Lead extraction procedure commenced to remove two leads; ra and rv.Although the extraction was challenging due to a high degree of scarring and placement of the superior vena cava (svc) coil, the rv lead was successfully extracted using several spectranetics devices.While attempting to extract the ra lead (which contained the spectranetics lld device) and while applying traction, the ra lead popped free while the the laser catheter (also in use during the procedure) was still in the subclavian area.A hole in the atrial appendage was discovered and rescue efforts began immediately.Repair was successful, and the patient survived the procedure.
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