Laser Lead Extraction During Venoarterial ECMO support.
Yalin YildirimJohannes PetersenTobias TönnisChristian DetterHermann ReichenspurnerSimon PechaPublished in: Brazilian journal of cardiovascular surgery (2021)
The treatment of valvular endocarditis in patients with cardiac implantable electrophysiological device (CIED) includes valvular surgery and lead extraction. This can be challenging in patients with severely reduced left ventricular ejection fraction (LVEF). Reduced LVEF in combination with sepsis and cardioplegic cardiac arrest can make weaning from cardiopulmonary bypass difficult. Some of these patients require venoarterial extracorporeal membrane oxygenation (VA-ECMO) for postcardiotomy syndrome. Lead extraction by manual traction is often not possible in cases with a long lead dwell time. Therefore, a lead extraction procedure with powered sheaths is required during the VA-ECMO support. We describe our technique for laser lead extraction during VA-ECMO support in a 64-year-old patient with triple valve endocarditis and lead vegetations.
Keyphrases
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- ejection fraction
- aortic stenosis
- respiratory failure
- left ventricular
- cardiac arrest
- aortic valve
- minimally invasive
- end stage renal disease
- intensive care unit
- newly diagnosed
- case report
- mitral valve
- high resolution
- acute kidney injury
- mass spectrometry
- transcatheter aortic valve replacement
- acute coronary syndrome
- high speed
- coronary artery bypass
- cardiopulmonary resuscitation
- surgical site infection
- patient reported outcomes