IS TRANSVENOUS LEADS EXTRACTION MORE HAZARDOUS PROCEDURE IN PATIENTS WITH LEAD DEPENDENT INFECTIVE ENDOCARDITIS?
A. Polewczyk1, A. Kutarski2, A. Tomaszewski 2, K. Boczar3, M. Janion1,4
1District Hospital, II Clinical Cardiology Department Kielce, Poland 2Medical University, Department of Cardiology Lublin, Poland 3Department of Electrocardiology, John Paul II Hospital, Krakow,
Poland 4The Jan Kochanowski University, Department Sciences of Healthy Kielce, Poland
Background: Transvenous leads extraction (TLE) consists the key-procedure in management of lead dependent infective endocarditis (LDIE). The assessment of TLE safety and effectiveness in this particular group of patients seems to be very important.
Methods: Analysis of data 1220 patients treated by TLE in single Reference Center in years 2006-2012 was conducted with separated of 320 LDIE patients. The comparative assessment of factors influencing to proceeding and effectiveness of TLE in LDIE and remaining patients was performed with evaluation of complete procedural success and clinical success in both groups of patients.
Results:
Conclusions: The LDIE patients represented more TLE risk factors: older age, more number of the leads- particularly abandoned and loop of the leads. Despite that the present study demonstrated a very high safety and effectiveness of TLE procedure in the large group of LDIE patients with low number of major complications and periprocedural mortality, comparable with non-infective TLE group. This observation confirms that TLE should be the basic of the treatment this very serious disease.
|
|
LDIE
|
Control group- non LDIE patients
|
P
|
| No of patients
Mean age [years (SN)]
Sex (women %) |
320
66,3 ±15,0
98 (30,6%)
|
900
63,75 ±17,3
358 (39,8%)
|
0,02
0,005
|
| Mean lead dwelling time before TLE [months (SD)] |
89,1
(±63,7)
|
83,7
(±64,7)
|
0,20 |
| Mean number of leads before TLE [SN] |
2,2
±0,82
|
1,9
±0,78
|
0,0001 |
| Unecessery loop of lead [%] |
84
26,2%
|
167
18,6%
|
0,004 |
| Number of abandoned leads (SD) |
0,31
(±0,67)
|
0,23
(±0,57)
|
0,04 |
| Procedure time [min (SD)] |
112
(±53)
|
110
(±46)
|
0,52 |
| Complete clinical success [%] |
299
93,4%
|
874
97,1%
|
0,004 |
| Major complications [%] |
6
1,9%
|
10
1,1%
|
0,28 |
| Periprocedural mortality [%] |
2
0,6%
|
2
0,2%
|
0,25 |
