Transvenous Lead Extraction in Adults With Congenital Heart Disease: Insights From a 20-Year Single-Center Experience
Safety and feasibility data on transvenous lead extraction (TLE) in the challenging population of adults with congenital heart disease (A-CHD) are limited. Herein, we report the results of TLE in A-CHD during a 20-year period. All consecutive TLE procedures in A-CHD were included in a monocentric pr...
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| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2018-02, Vol.11 (2), p.e005409-e005409 |
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| creator | Gourraud, Jean-Baptiste Chaix, Marie-A Shohoudi, Azadeh Pagé, Pierre Dubuc, Marc Thibault, Bernard Poirier, Nancy C. Dore, Annie Marcotte, François Mongeon, François-Pierre Asgar, Anita W. Ibrahim, Réda Khairy, Paul Mondésert, Blandine |
| description | Safety and feasibility data on transvenous lead extraction (TLE) in the challenging population of adults with congenital heart disease (A-CHD) are limited. Herein, we report the results of TLE in A-CHD during a 20-year period.
All consecutive TLE procedures in A-CHD were included in a monocentric prospective registry from 1996. A total of 121 leads were extracted in 49 A-CHD (median age, 38 years; 51% men) during 71 TLE procedures. Twenty-four (49%) patients had transposition of the great arteries. Main indications for extraction were infection in 34 (48%) and lead failure in 22 (31%). A laser sheath was required for 56 (46%) leads and a femoral approach for 10 (8%). Complete TLE was achieved for 111 leads (92%). In multivariable analysis, lead duration (odds ratio, 1.02; 95% confidence interval, 1.00-1.04; |
| doi_str_mv | 10.1161/CIRCEP.117.005409 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2002209545</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2002209545</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2980-2347e3a25a9a8bd0e8b1021f4f2182975cf9c4ac8499558bab1f595b8ca915653</originalsourceid><addsrcrecordid>eNo9kE1v1DAQhi0Eoh_wA7ggH7mkzDh2YnOrwpautBIIihCnyPFOdg1ZZ2snFP59XaXlMPJ7eObV-GHsDcIFYoXvm_XXZvUl5_oCQEkwz9gpGolFCVo-f8oozQk7S-kXQIUaq5fsRBhZ1nUFp2y-iTakPxTGOfEN2S1f_Z2idZMfA_eBX27nYUr8h5_2vBnDjoKf7MCvycaJf_SJbKIPfB2S3-0zdxXHA7dcQPEzE_ybD7uBiobCRDE3Hyl6Co5esRe9HRK9fnzP2fer1U1zXWw-f1o3l5vCCaOhEKWsqbRCWWN1twXSHYLAXvYCtTC1cr1x0jotjVFKd7bDXhnVaWcNqkqV5-zd0nuM4-1MaWoPPjkaBhsof7gVAEKAUfIBxQV1cUwpUt8eoz_Y-K9FaB9st4vtnOt2sZ133j7Wz92Btv83nvRmQC7A3ThkA-n3MN9RbPdkh2nfApZlLU1ZCEAN-RYo8iCU979Tidg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2002209545</pqid></control><display><type>article</type><title>Transvenous Lead Extraction in Adults With Congenital Heart Disease: Insights From a 20-Year Single-Center Experience</title><source>MEDLINE</source><source>American Heart Association</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Gourraud, Jean-Baptiste ; Chaix, Marie-A ; Shohoudi, Azadeh ; Pagé, Pierre ; Dubuc, Marc ; Thibault, Bernard ; Poirier, Nancy C. ; Dore, Annie ; Marcotte, François ; Mongeon, François-Pierre ; Asgar, Anita W. ; Ibrahim, Réda ; Khairy, Paul ; Mondésert, Blandine</creator><creatorcontrib>Gourraud, Jean-Baptiste ; Chaix, Marie-A ; Shohoudi, Azadeh ; Pagé, Pierre ; Dubuc, Marc ; Thibault, Bernard ; Poirier, Nancy C. ; Dore, Annie ; Marcotte, François ; Mongeon, François-Pierre ; Asgar, Anita W. ; Ibrahim, Réda ; Khairy, Paul ; Mondésert, Blandine</creatorcontrib><description>Safety and feasibility data on transvenous lead extraction (TLE) in the challenging population of adults with congenital heart disease (A-CHD) are limited. Herein, we report the results of TLE in A-CHD during a 20-year period.
All consecutive TLE procedures in A-CHD were included in a monocentric prospective registry from 1996. A total of 121 leads were extracted in 49 A-CHD (median age, 38 years; 51% men) during 71 TLE procedures. Twenty-four (49%) patients had transposition of the great arteries. Main indications for extraction were infection in 34 (48%) and lead failure in 22 (31%). A laser sheath was required for 56 (46%) leads and a femoral approach for 10 (8%). Complete TLE was achieved for 111 leads (92%). In multivariable analysis, lead duration (odds ratio, 1.02; 95% confidence interval, 1.00-1.04;
<0.01) and number of previous cardiac surgeries (odds ratio, 2.65; 95% confidence interval, 1.52-4.67;
<0.01) were predictive of TLE failure. No perioperative death or pericardial effusion was observed. Subpulmonary atrioventricular valve regurgitation increased in 8 patients (5 with transposition of the great arteries) and was independently associated with an implantable cardioverter defibrillator lead (odds ratio, 9.69; 95% confidence interval, 1.31-71.64;
=0.03) and valvular vegetation (odds ratio, 7.29; 95% confidence interval, 1.32-40.51;
=0.02). After a median of 54 (19-134) months of follow-up after the first TLE, 3 deaths occurred independently from lead management.
Despite complex anatomic issues, TLE can be achieved successfully in most A-CHD using advanced extraction techniques. Subpulmonary atrioventricular valve regurgitation is a prevalent complication, particularly in patients with transposition of the great arteries.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.117.005409</identifier><identifier>PMID: 29437760</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Adult ; Catheterization, Peripheral - methods ; Defibrillators, Implantable - adverse effects ; Device Removal - methods ; Electrodes, Implanted - adverse effects ; Equipment Failure ; Feasibility Studies ; Female ; Femoral Vein ; Follow-Up Studies ; Forecasting ; Heart Defects, Congenital - therapy ; Humans ; Incidence ; Male ; Middle Aged ; Pacemaker, Artificial - adverse effects ; Postoperative Complications - epidemiology ; Prospective Studies ; Quebec - epidemiology ; Survival Rate - trends</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2018-02, Vol.11 (2), p.e005409-e005409</ispartof><rights>American Heart Association, Inc.</rights><rights>2018 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2980-2347e3a25a9a8bd0e8b1021f4f2182975cf9c4ac8499558bab1f595b8ca915653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29437760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gourraud, Jean-Baptiste</creatorcontrib><creatorcontrib>Chaix, Marie-A</creatorcontrib><creatorcontrib>Shohoudi, Azadeh</creatorcontrib><creatorcontrib>Pagé, Pierre</creatorcontrib><creatorcontrib>Dubuc, Marc</creatorcontrib><creatorcontrib>Thibault, Bernard</creatorcontrib><creatorcontrib>Poirier, Nancy C.</creatorcontrib><creatorcontrib>Dore, Annie</creatorcontrib><creatorcontrib>Marcotte, François</creatorcontrib><creatorcontrib>Mongeon, François-Pierre</creatorcontrib><creatorcontrib>Asgar, Anita W.</creatorcontrib><creatorcontrib>Ibrahim, Réda</creatorcontrib><creatorcontrib>Khairy, Paul</creatorcontrib><creatorcontrib>Mondésert, Blandine</creatorcontrib><title>Transvenous Lead Extraction in Adults With Congenital Heart Disease: Insights From a 20-Year Single-Center Experience</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>Safety and feasibility data on transvenous lead extraction (TLE) in the challenging population of adults with congenital heart disease (A-CHD) are limited. Herein, we report the results of TLE in A-CHD during a 20-year period.
All consecutive TLE procedures in A-CHD were included in a monocentric prospective registry from 1996. A total of 121 leads were extracted in 49 A-CHD (median age, 38 years; 51% men) during 71 TLE procedures. Twenty-four (49%) patients had transposition of the great arteries. Main indications for extraction were infection in 34 (48%) and lead failure in 22 (31%). A laser sheath was required for 56 (46%) leads and a femoral approach for 10 (8%). Complete TLE was achieved for 111 leads (92%). In multivariable analysis, lead duration (odds ratio, 1.02; 95% confidence interval, 1.00-1.04;
<0.01) and number of previous cardiac surgeries (odds ratio, 2.65; 95% confidence interval, 1.52-4.67;
<0.01) were predictive of TLE failure. No perioperative death or pericardial effusion was observed. Subpulmonary atrioventricular valve regurgitation increased in 8 patients (5 with transposition of the great arteries) and was independently associated with an implantable cardioverter defibrillator lead (odds ratio, 9.69; 95% confidence interval, 1.31-71.64;
=0.03) and valvular vegetation (odds ratio, 7.29; 95% confidence interval, 1.32-40.51;
=0.02). After a median of 54 (19-134) months of follow-up after the first TLE, 3 deaths occurred independently from lead management.
Despite complex anatomic issues, TLE can be achieved successfully in most A-CHD using advanced extraction techniques. Subpulmonary atrioventricular valve regurgitation is a prevalent complication, particularly in patients with transposition of the great arteries.</description><subject>Adult</subject><subject>Catheterization, Peripheral - methods</subject><subject>Defibrillators, Implantable - adverse effects</subject><subject>Device Removal - methods</subject><subject>Electrodes, Implanted - adverse effects</subject><subject>Equipment Failure</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Femoral Vein</subject><subject>Follow-Up Studies</subject><subject>Forecasting</subject><subject>Heart Defects, Congenital - therapy</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pacemaker, Artificial - adverse effects</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Quebec - epidemiology</subject><subject>Survival Rate - trends</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1v1DAQhi0Eoh_wA7ggH7mkzDh2YnOrwpautBIIihCnyPFOdg1ZZ2snFP59XaXlMPJ7eObV-GHsDcIFYoXvm_XXZvUl5_oCQEkwz9gpGolFCVo-f8oozQk7S-kXQIUaq5fsRBhZ1nUFp2y-iTakPxTGOfEN2S1f_Z2idZMfA_eBX27nYUr8h5_2vBnDjoKf7MCvycaJf_SJbKIPfB2S3-0zdxXHA7dcQPEzE_ybD7uBiobCRDE3Hyl6Co5esRe9HRK9fnzP2fer1U1zXWw-f1o3l5vCCaOhEKWsqbRCWWN1twXSHYLAXvYCtTC1cr1x0jotjVFKd7bDXhnVaWcNqkqV5-zd0nuM4-1MaWoPPjkaBhsof7gVAEKAUfIBxQV1cUwpUt8eoz_Y-K9FaB9st4vtnOt2sZ133j7Wz92Btv83nvRmQC7A3ThkA-n3MN9RbPdkh2nfApZlLU1ZCEAN-RYo8iCU979Tidg</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Gourraud, Jean-Baptiste</creator><creator>Chaix, Marie-A</creator><creator>Shohoudi, Azadeh</creator><creator>Pagé, Pierre</creator><creator>Dubuc, Marc</creator><creator>Thibault, Bernard</creator><creator>Poirier, Nancy C.</creator><creator>Dore, Annie</creator><creator>Marcotte, François</creator><creator>Mongeon, François-Pierre</creator><creator>Asgar, Anita W.</creator><creator>Ibrahim, Réda</creator><creator>Khairy, Paul</creator><creator>Mondésert, Blandine</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Transvenous Lead Extraction in Adults With Congenital Heart Disease: Insights From a 20-Year Single-Center Experience</title><author>Gourraud, Jean-Baptiste ; Chaix, Marie-A ; Shohoudi, Azadeh ; Pagé, Pierre ; Dubuc, Marc ; Thibault, Bernard ; Poirier, Nancy C. ; Dore, Annie ; Marcotte, François ; Mongeon, François-Pierre ; Asgar, Anita W. ; Ibrahim, Réda ; Khairy, Paul ; Mondésert, Blandine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2980-2347e3a25a9a8bd0e8b1021f4f2182975cf9c4ac8499558bab1f595b8ca915653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Catheterization, Peripheral - methods</topic><topic>Defibrillators, Implantable - adverse effects</topic><topic>Device Removal - methods</topic><topic>Electrodes, Implanted - adverse effects</topic><topic>Equipment Failure</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Femoral Vein</topic><topic>Follow-Up Studies</topic><topic>Forecasting</topic><topic>Heart Defects, Congenital - therapy</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pacemaker, Artificial - adverse effects</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Quebec - epidemiology</topic><topic>Survival Rate - trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gourraud, Jean-Baptiste</creatorcontrib><creatorcontrib>Chaix, Marie-A</creatorcontrib><creatorcontrib>Shohoudi, Azadeh</creatorcontrib><creatorcontrib>Pagé, Pierre</creatorcontrib><creatorcontrib>Dubuc, Marc</creatorcontrib><creatorcontrib>Thibault, Bernard</creatorcontrib><creatorcontrib>Poirier, Nancy C.</creatorcontrib><creatorcontrib>Dore, Annie</creatorcontrib><creatorcontrib>Marcotte, François</creatorcontrib><creatorcontrib>Mongeon, François-Pierre</creatorcontrib><creatorcontrib>Asgar, Anita W.</creatorcontrib><creatorcontrib>Ibrahim, Réda</creatorcontrib><creatorcontrib>Khairy, Paul</creatorcontrib><creatorcontrib>Mondésert, Blandine</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gourraud, Jean-Baptiste</au><au>Chaix, Marie-A</au><au>Shohoudi, Azadeh</au><au>Pagé, Pierre</au><au>Dubuc, Marc</au><au>Thibault, Bernard</au><au>Poirier, Nancy C.</au><au>Dore, Annie</au><au>Marcotte, François</au><au>Mongeon, François-Pierre</au><au>Asgar, Anita W.</au><au>Ibrahim, Réda</au><au>Khairy, Paul</au><au>Mondésert, Blandine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transvenous Lead Extraction in Adults With Congenital Heart Disease: Insights From a 20-Year Single-Center Experience</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>11</volume><issue>2</issue><spage>e005409</spage><epage>e005409</epage><pages>e005409-e005409</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>Safety and feasibility data on transvenous lead extraction (TLE) in the challenging population of adults with congenital heart disease (A-CHD) are limited. Herein, we report the results of TLE in A-CHD during a 20-year period.
All consecutive TLE procedures in A-CHD were included in a monocentric prospective registry from 1996. A total of 121 leads were extracted in 49 A-CHD (median age, 38 years; 51% men) during 71 TLE procedures. Twenty-four (49%) patients had transposition of the great arteries. Main indications for extraction were infection in 34 (48%) and lead failure in 22 (31%). A laser sheath was required for 56 (46%) leads and a femoral approach for 10 (8%). Complete TLE was achieved for 111 leads (92%). In multivariable analysis, lead duration (odds ratio, 1.02; 95% confidence interval, 1.00-1.04;
<0.01) and number of previous cardiac surgeries (odds ratio, 2.65; 95% confidence interval, 1.52-4.67;
<0.01) were predictive of TLE failure. No perioperative death or pericardial effusion was observed. Subpulmonary atrioventricular valve regurgitation increased in 8 patients (5 with transposition of the great arteries) and was independently associated with an implantable cardioverter defibrillator lead (odds ratio, 9.69; 95% confidence interval, 1.31-71.64;
=0.03) and valvular vegetation (odds ratio, 7.29; 95% confidence interval, 1.32-40.51;
=0.02). After a median of 54 (19-134) months of follow-up after the first TLE, 3 deaths occurred independently from lead management.
Despite complex anatomic issues, TLE can be achieved successfully in most A-CHD using advanced extraction techniques. Subpulmonary atrioventricular valve regurgitation is a prevalent complication, particularly in patients with transposition of the great arteries.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>29437760</pmid><doi>10.1161/CIRCEP.117.005409</doi></addata></record> |
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| ispartof | Circulation. Arrhythmia and electrophysiology, 2018-02, Vol.11 (2), p.e005409-e005409 |
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| source | MEDLINE; American Heart Association; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Catheterization, Peripheral - methods Defibrillators, Implantable - adverse effects Device Removal - methods Electrodes, Implanted - adverse effects Equipment Failure Feasibility Studies Female Femoral Vein Follow-Up Studies Forecasting Heart Defects, Congenital - therapy Humans Incidence Male Middle Aged Pacemaker, Artificial - adverse effects Postoperative Complications - epidemiology Prospective Studies Quebec - epidemiology Survival Rate - trends |
| title | Transvenous Lead Extraction in Adults With Congenital Heart Disease: Insights From a 20-Year Single-Center Experience |
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