Laser Lead Extraction During Venoarterial ECMO support

• Autor(a) principal: Yildirim,Yalin
• Data de Publicação: 2022
• Outros Autores: Petersen,Johannes, Tönnis,Tobias, Detter,Christian, Reichenspurner,Hermann, Pecha,Simon
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000300401
• topic: Extracorporeal Membrane Oxygenation; Stroke Volume; Cardiopulmonary Bypass; Ventricular Function; Left; Heart Arrest; Endocarditis; Sepsis

Abstract The treatment of valvular endocarditis in patients with cardiac implantable electrophysiological device (CIED) includes valvular surgery and lead extraction. This can be challenging in patients with severely reduced left ventricular ejection fraction (LVEF). Reduced LVEF in combination with sepsis and cardioplegic cardiac arrest can make weaning from cardiopulmonary bypass difficult. Some of these patients require venoarterial extracorporeal membrane oxygenation (VA-ECMO) for postcardiotomy syndrome. Lead extraction by manual traction is often not possible in cases with a long lead dwell time. Therefore, a lead extraction procedure with powered sheaths is required during the VA-ECMO support. We describe our technique for laser lead extraction during VA-ECMO support in a 64-year-old patient with triple valve endocarditis and lead vegetations.