D
Patient 1
A LEAD EXTRACTION PROCEDURE COMMENCED TO REMOVE A RIGHT ATRIUM (RA) AND A RIGHT VENTRICLE (RV) LEAD DUE TO CIED SYSTEM/POCKET INFECTION. THERE WERE MULTIPLE DEVICES USED BY THE PHYSICIAN TO AID IN THE REMOVAL OF THE LEADS. THE RV LEAD WAS EXTRACTED SUCCESSFULLY. DURING REMOVAL OF RA LEAD WITH THE SPECTRANETICS 16 FR GLIDELIGHT LASER SHEATH, THE PATIENT'S BLOOD PRESSURE DROPPED. FLUOROSCOPY SHOWED THAT THE RIGHT LUNG COLLAPSED AND HAD FILLED WITH BLOOD. RESCUE INTERVENTION COMMENCED IMMEDIATELY. A CHEST TUBE WAS PLACED ON THE PATIENT'' RIGHT SIDE AND A SMALL HOLE IN THE HEART WAS DETERMINED BY DIGITAL SUBTRACTION ANGIOGRAPHY (DSA). AFTER ABOUT TEN MINUTES, THE SMALL 3MM HOLE IN SVC HAD SEALED OFF BY COAGULATION OR CLOTTING. THE CHEST TUBE HAD AN OUTPUT OF 1600ML. PRESSURE NORMALIZED AND THE PATIENT'S REIMPLANTATION WAS SCHEDULED FOR THE FOLLOWING DAY. REIMPLANTATION WAS SUCCESSFUL AND THE PATIENT SURVIVED THE PROCEDURES. THERE WAS NO REPORTED MALFUNCTION OF THE SPECTRANETICS DEVICES.