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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
| Dokumentenart | Artikel | ||||
| Titel eines Journals oder einer Zeitschrift | Journal of Cardiothoracic Surgery | ||||
| Verlag: | BMC | ||||
|---|---|---|---|---|---|
| Ort der Veröffentlichung: | LONDON | ||||
| Band: | 13 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 1 | ||||
| Seitenbereich: | S. 1-5 | ||||
| Datum | 1 Dezember 2018 | ||||
| Institutionen | Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medizin > Lehrstuhl für Innere Medizin II | ||||
| Identifikationsnummer |
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| Stichwörter / Keywords | PACEMAKER; IMPLANTATION; EXTRACTION; Pacemaker; Implantable cardioverter defibrillator; Lead exchange; Polypropylene sheath; Venous puncture | ||||
| Dewey-Dezimal-Klassifikation | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status | Veröffentlicht | ||||
| Begutachtet | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden | Ja | ||||
| URN der UB Regensburg | urn:nbn:de:bvb:355-epub-384092 | ||||
| Dokumenten-ID | 38409 |
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