Dorota Nowosielecka1, Anna Polewczyk2,3, Wojciech Jacheć4, Łukasz Tułecki5, Konrad Tomków5, Paweł Stefańczyk1, Andrzej Kleinrok1, Andrzej Kutarski6. 1. Department of Cardiology, The Pope John Paul II Province Hospital of Zamosc, Zamosc, Poland. 2. Collegium Medicum, The Jan Kochanowski University, Kielce, Poland. 3. Department of Cardiac Surgery, Swietokrzyskie Cardiology Center, Kielce, Poland. 4. 2nd Department of Cardiology, Silesian Medical University, Zabrze, Poland. 5. Department of Cardiac Surgery, The Pope John Paul II Province Hospital of Zamosc, Zamosc, Poland. 6. Department of Cardiology, Medical University, Lublin, Poland.
Abstract
AIMS: The usefulness of transesophageal echocardiographic (TEE) monitoring for transvenous lead extraction (TLE) procedures is still controversial. The purpose of the current study was to present new TEE values in detecting invisible events in fluoroscopy and preventing the development of dangerous complications. METHODS: From 2015 to 2019, a total of 1026 procedures were performed in single TLE center. In total, 1108 leads had been extracted with a mean lead dwell time of 115.8 ± 77.6 months. Continuous TEE was used in 936 patients with a mean age of 67.1 ± 14.4 years. RESULTS: Preprocedure examination revealed looped leads in 181 (19.3%) patients, dry cardiac perforation in 151 (16.1%), lead-to-lead adhesion in 172 (18.4%), lead adhesion to the myocardium in 317 (33.9%), and vegetations in 119 (12.7%) patients. Intra-procedural TEE demonstrated pulling on the atrial wall, ventricular wall, or tricuspid valve in 380 (40.5%), 235 (25.1%), and 78 (8.3%) patients, respectively. Acute tamponade requiring sternotomy occurred in 11 (1.1%) patients. Migration of vegetation or connective tissue fragments were seen in 69 (7.3%) and 111 (11.8%) patients, respectively. After procedure, TEE was helpful in navigating an implantation, a new lead in 97 (10.3%) patients, and removing the remnants of lead/silicone insulation in 50 (5.3%) patients. CONCLUSION: Real time transesophageal echocardiography for the guidance of transvenous lead extraction informs the operator about the danger of manipulations close to delicate cardiac structures and whether immediate modification to the plan of lead removal is necessary in order to prevent the occurrence of unwanted events.
AIMS: The usefulness of transesophageal echocardiographic (TEE) monitoring for transvenous lead extraction (TLE) procedures is still controversial. The purpose of the current study was to present new TEE values in detecting invisible events in fluoroscopy and preventing the development of dangerous complications. METHODS: From 2015 to 2019, a total of 1026 procedures were performed in single TLE center. In total, 1108 leads had been extracted with a mean lead dwell time of 115.8 ± 77.6 months. Continuous TEE was used in 936 patients with a mean age of 67.1 ± 14.4 years. RESULTS: Preprocedure examination revealed looped leads in 181 (19.3%) patients, dry cardiac perforation in 151 (16.1%), lead-to-lead adhesion in 172 (18.4%), lead adhesion to the myocardium in 317 (33.9%), and vegetations in 119 (12.7%) patients. Intra-procedural TEE demonstrated pulling on the atrial wall, ventricular wall, or tricuspid valve in 380 (40.5%), 235 (25.1%), and 78 (8.3%) patients, respectively. Acute tamponade requiring sternotomy occurred in 11 (1.1%) patients. Migration of vegetation or connective tissue fragments were seen in 69 (7.3%) and 111 (11.8%) patients, respectively. After procedure, TEE was helpful in navigating an implantation, a new lead in 97 (10.3%) patients, and removing the remnants of lead/silicone insulation in 50 (5.3%) patients. CONCLUSION: Real time transesophageal echocardiography for the guidance of transvenous lead extraction informs the operator about the danger of manipulations close to delicate cardiac structures and whether immediate modification to the plan of lead removal is necessary in order to prevent the occurrence of unwanted events.
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Andrzej Kleinrok; Łukasz Tułecki; Andrzej Kutarski Journal: Cardiovasc Diagn Ther Date: 2021-04
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Łukasz Tułecki; Andrzej Kleinrok; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2021-02-14 Impact factor: 3.390
Authors: Łukasz Tułecki; Anna Polewczyk; Wojciech Jacheć; Dorota Nowosielecka; Konrad Tomków; Paweł Stefańczyk; Jarosław Kosior; Krzysztof Duda; Maciej Polewczyk; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2021-08-28 Impact factor: 3.390
Authors: Anna Polewczyk; Wojciech Jacheć; Dorota Nowosielecka; Andrzej Tomaszewski; Wojciech Brzozowski; Dorota Szczęśniak-Stańczyk; Krzysztof Duda; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2022-09-27 Impact factor: 4.614
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Łukasz Tułecki; Paweł Stefańczyk; Andrzej Kutarski Journal: Int J Environ Res Public Health Date: 2022-10-01 Impact factor: 4.614
Authors: Dorota Nowosielecka; Wojciech Jacheć; Anna Polewczyk; Łukasz Tułecki; Konrad Tomków; Paweł Stefańczyk; Andrzej Tomaszewski; Wojciech Brzozowski; Dorota Szcześniak-Stańczyk; Andrzej Kleinrok; Andrzej Kutarski Journal: J Clin Med Date: 2020-05-08 Impact factor: 4.241
Authors: Paweł Stefańczyk; Dorota Nowosielecka; Łukasz Tułecki; Konrad Tomków; Anna Polewczyk; Wojciech Jacheć; Andrzej Kleinrok; Wojciech Borzęcki; Andrzej Kutarski Journal: Vasc Health Risk Manag Date: 2021-08-05