In this issue of HeartRhythm, Azarrafiy et al
1
report the findings of the initial use of a rescue device that is intended to tamponade
a rent in the superior vena cava (SVC) that can occur during the extraction of chronically
implanted pacemaker and defibrillator leads (Bridge, Spectranetics, Colorado Springs,
CO). They mined data from the Manufacturer and User Facility Device Experience (MAUDE)
database, a Food and Drug Administration registry of adverse events that are related
to the use of medical devices. There were 9 uses of the balloon in confirmed SVC tears
and 26 tears in which the rescue balloon was not used. All the patients in whom the
balloon was used survived to discharge, whereas only 50% of those without balloon
usage survived. Likewise, in 4 of those 9 cases, the SVC was repaired without the
need for cardiopulmonary bypass, thereby making the procedure faster. While this report
does not involve rigorously collected data, it reveals initial data that are quite
compelling.To read this article in full you will need to make a payment
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References
- Compliant endovascular balloon reduces the lethality of superior vena cava tears.Heart Rhythm. 2017; 14: 1400-1404
- Outcomes of patients requiring emergent surgical or endovascular intervention for catastrophic complications during transvenous lead extraction.Heart Rhythm. 2014; 11: 419-425
- Balloon tamponade of the superior vena cava and the management of catastrophic complications of cardiac lead extraction.Heart Rhythm. 2017; 14: 761-762
Article info
Publication history
Published online: June 10, 2017
Footnotes
Dr Crossley is a consultant and speaker for Medtronic, Boston Scientific, and Spectranetics.
Identification
Copyright
© 2017 Published by Elsevier Inc. on behalf of Heart Rhythm Society.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Compliant endovascular balloon reduces the lethality of superior vena cava tears during transvenous lead extractionsHeart RhythmVol. 14Issue 9
- PreviewSuperior vena cava (SVC) lacerations have been identified as the most lethal complication encountered during cardiac implantable electronic device lead extraction. The case fatality rate of these events approximates 50% due to rapid exsanguination. A novel, compliant balloon specifically designed for use in the SVC may provide hemostasis in the event of endovascular perforation. By temporarily occluding the compromised vessel, the endovascular balloon should delay hemodynamic collapse, provide a more controlled surgical field for repair, and thereby reduce the mortality of SVC tears complicating transvenous lead extraction.
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