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Keyser, Andreas ; Schopka, Simon ; Jungbauer, Carsten ; Foltan, Maik ; Schmid, Christof

Early-BYRD: alternative early pacing and defibrillation lead replacement avoiding venous puncture

Keyser, Andreas, Schopka, Simon, Jungbauer, Carsten, Foltan, Maik und Schmid, Christof (2018) Early-BYRD: alternative early pacing and defibrillation lead replacement avoiding venous puncture. Journal of Cardiothoracic Surgery 13 (1), S. 1-5.

Veröffentlichungsdatum dieses Volltextes: 01 Mrz 2019 12:31
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.38409


Zusammenfassung

Background: In cases of lead failure after implantation of pacemakers (PM) or implantable cardioverter defibrillators (ICD) early lead replacement may be challenging. Puncture of the subclavian vein bears possible complications such as pneumothorax, hematothorax, and damage of leads to be left in place. To avoid venous puncture PM or ICD leads were replaced using a flexible polypropylene sheath ...

Background: In cases of lead failure after implantation of pacemakers (PM) or implantable cardioverter defibrillators (ICD) early lead replacement may be challenging. Puncture of the subclavian vein bears possible complications such as pneumothorax, hematothorax, and damage of leads to be left in place. To avoid venous puncture PM or ICD leads were replaced using a flexible polypropylene sheath (Byrd-sheath). Method: From January 2010 through December 2017, 55 patients underwent early lead exchange avoiding venous puncture. Early lead exchange for this study was defined as a reintervention within 14 days after the initial lead implantation. The connector of the malfunctioning lead was cut off, and stabilized by a stiff stylet. After having cut off the plastic knob of the stylet, the lead was passed through the polypropylene sheath and the latter advanced into the subclavian vein with gentle rotational movements to gain access to the subclavian vein. After lead removal the polypropylene sheath was replaced by a peel away sheath a new lead inserted. Results: Overall, 23 defibrillation leads and 34 pacing leads (16 right atrial leads, 17 right ventricular leads, and 1 left ventricular lead) were successfully explanted. Access to the subclavian vein was uneventful, and blood loss minimal. Radiation exposure and fluoroscopy time were also negligible. Conclusion: The Byrd-sheath technique proved to be safe and successful in providing vein access within 2 weeks after initial lead implantation using the previously implanted lead and thus avoiding puncture of the subclavian vein.



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftJournal of Cardiothoracic Surgery
Verlag:BMC
Ort der Veröffentlichung:LONDON
Band:13
Nummer des Zeitschriftenheftes oder des Kapitels:1
Seitenbereich:S. 1-5
Datum1 Dezember 2018
InstitutionenMedizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie
Medizin > Lehrstuhl für Innere Medizin II
Identifikationsnummer
WertTyp
10.1186/s13019-018-0795-5DOI
Stichwörter / KeywordsPACEMAKER; IMPLANTATION; EXTRACTION; Pacemaker; Implantable cardioverter defibrillator; Lead exchange; Polypropylene sheath; Venous puncture
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-384092
Dokumenten-ID38409

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