Lead Extraction of Very Old Leads—A GALLERY Subgroup Analysis

S. Pecha; H. Burger; D.U. Chung; T. Madej; A. Maali; B. Osswald; R. De Simone; N. PD Dr. med. Monsefi; V. Ziaukas; S. Erler; H. Elfarra; M. Perthel; M. Wehbe; N. Ghaffari; T. Sandhaus; H. Busk; JD. Schmitto; V. Bärsch; J. Easo; M. Albert; H. Treede; H. Nägele; D. Zenker; Y. Hegazy; K. Hassan; M. Knaut; H. Reichenspurner; S. Willems; C. Butter; S. Hakmi

doi:10.1055/s-0044-1780692

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2024; 72(S 01): S1-S68
DOI: 10.1055/s-0044-1780692

Monday, 19 February

Was macht die Herzchirurgie bei Vorhofflimmern?

Lead Extraction of Very Old Leads—A GALLERY Subgroup Analysis

Authors

S. Pecha

¹University Heart & Vascular Center Hamburg, Hamburg, Deutschland
H. Burger

²Kerckhoff-Klinik GmbH, Benekestraße, Bad Nauheim, Deutschland, Bad Nauheim, Deutschland
D.U. Chung

³Asklepios Klinik St. Georg, Hamburg, Deutschland
T. Madej

⁴Herzzentrum Dresden Universitätsklinik, Herzchirurgie, Dresden, Deutschland
A. Maali

⁵Herzzentrum, Coswig (Anhalt), Deutschland
B. Osswald

⁶Johanniter-Krankenhaus Duisburg-Rheinhausen, Duisburg, Deutschland
R. De Simone

⁷Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
N. PD Dr. med. Monsefi

⁸Helios Klinikum Siegburg, Siegburg, Deutschland
V. Ziaukas

⁹Schüchtermann-Klinik, Bad Rothenfelde, Deutschland
S. Erler

¹⁰Department of Cardiothoracic Surgery, Bad Bevensen, Deutschland
H. Elfarra

¹¹Heart Center Duisburg, Duisburg, Deutschland
M. Perthel

¹²Heart centre Bad Segeberg, Bad Segeberg, Deutschland
M. Wehbe

⁹Schüchtermann-Klinik, Bad Rothenfelde, Deutschland
N. Ghaffari

¹³Klinikum Karlsruhe, Karlsruhe, Deutschland
T. Sandhaus

¹⁴Jena, Deutschland
H. Busk

¹⁵Uniklinik Magdeburg, Magdeburg, Deutschland
JD. Schmitto

¹⁶Hannover, Deutschland
V. Bärsch

¹⁷St. Marien-Krankenhaus Siegen, Siegen, Deutschland
J. Easo

¹⁸Hospital Oldenburg, Oldenburg, Deutschland
M. Albert

¹⁹Robert-Bosch-Hospital, Stuttgart, Deutschland
H. Treede

²⁰Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
H. Nägele

²¹Albertinen Krankenhaus, Hamburg, Deutschland
D. Zenker

²²Göttingen, Deutschland
Y. Hegazy

²³MediClin Heart Center Lahr / Baden, Lahr/Schwarzwald, Deutschland
K. Hassan

²⁴Department of Cardiac Surgery, Asklepios Klinik St. Georg, Hamburg, Hamburg, Germany, Hamburg, Deutschland
M. Knaut

⁴Herzzentrum Dresden Universitätsklinik, Herzchirurgie, Dresden, Deutschland
H. Reichenspurner

²⁵Hamburg, Deutschland
S. Willems

³Asklepios Klinik St. Georg, Hamburg, Deutschland
C. Butter

²⁶Immanuel Herzzentrum Brandenburg, Bernau bei Berlin, Deutschland
S. Hakmi

²⁷Asklepios St. Georg Clinic, Hamburg, Deutschland

Abstract

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Background: Transvenous lead extraction using powered extraction sheaths is a well-established procedure. Lead dwell time has been described as a risk factor for procedure-related complications and extraction failure. We here investigated safety and efficacy of laser lead extraction in a GALLERY subgroup with leads implanted for ≥10 years.

Methods: A subgroup analysis of all patients (n = 857) with at least one lead aged ≥ 10 years from the German Laser Lead Extraction Registry (GALLERY) was performed. Primary extraction method was Laser lead extraction, with additional use of mechanical rotational sheaths or femoral snares, if necessary. Retrospective data analysis was performed.

Results: Mean patient’s age was 70.4 ± 13.7 years, 73.2% were male. 2107 leads were treated in 857 patients. The median lead dwell time of treated leads was 162 months (Range 120–457 months). Local- (40.1%) or systemic (30.1%) infection were the most frequent indications for lead extraction. Clinical success was achieved in 96.5%, while complete procedural success was 83.3%. Overall complication rate was 5.5%, including 3.2% major- and 2.3% minor complications. Procedure-related mortality was 0.6%, while overall in-hospital mortality was 3.6%.

Conclusion: In our study, transvenous lead extraction in leads aged ≥10 years, has shown reasonable success and complication rates with a low procedure related mortality. Therefore, increased lead age should not be a contraindication for lead extraction.