[177008132]
Patient date of birth unavailable. Patient weight unavailable.
Patient Sequence No: 1, Text Type: N, H10
[177008133]
A lead extraction procedure commenced to remove two leads: a right atrial (ra) lead and a right ventricular (rv) lead due to infection. The physician attempted to retract the screws on the distal ends of the rv and ra but were unsuccessful. Spectranetics lead locking devices (ldl's) were placed inside each lead to provide traction. The physician began using a spectranetics 14f glidelight device for lead removal attempt, but encountered stalled progression in the subclavian region. A spectranetics 10f sightrail device was then used with no further progress. The team then attempted to use a snare from a femoral insertion site but was unsuccessful. They then used a metal sheath (cook medical) and were able to get progress using this, along with the glidelight and sightrail devices. They encountered stalled progression in the superior vena cava (svc) region. The physician then upsized to a 16f glidelight device; however the patient's blood pressure dropped. There was no sign of a cardiac effusion but a shadow was noticed in the patient's right chest. The patient was transferred to icu and there it was confirmed that the patient's blood pressure continued to drop. It was decided to commence rescue efforts, including sternotomy. A small hole was discovered at the svc/ra junction. The repair to the hole was successfully completed. Both the ra and rv leads and ldl's within them were cut, capped, and remained in the patient, and it was noted that the physician did not attempt to unlock either lld prior to cutting and capping the leads/ldl's. There is no reported malfunction of any spectranetics devices used in the procedure. The patient survived. This report captures the injury to the svc/ra junction while the glidelight device was in use.
Patient Sequence No: 1, Text Type: D, B5