Introduction: The most difficult point of endocardial lead extraction (LE) problem is connected with large lead-assotiated vegetations .Our group developed a pump-off approach to LE which allows to avoid damage of targeted leads and prevent pulmonary artery embolization.
Methods: The surgical approach includes sternotomy, canulation of aorta, SCV, ICV. The procedure is performed using assisted circulation and beating heart technique. After RA incision targeted leads are cut off and central parts of them are extracted. A special tool and visual control are used at this stage of operation. Peripheral parts of leads are extracted together with CIED through pocket incision. Our experience includes 18 cases. In addition TV prosthesis was performed in 11 cases, TV+MV prosthesis – in 5 cases and CABG – in 4 cases.
Results: Complete procedural success was achieved in 17 cases (94,4%, 51 leads extracted). Clinical procedural success was achieved in 1 case (5,6%, lead part 10 cm long was abandoned ). No hospital mortality or after-surgical complications were observed.
Conclusions: The method has high clinical efficacy. Its reproducibility allows to use it widely in all cardiosurgery departments.