scholarly journals Retained Pacemaker Lead Fragment-Induced Fibrosis, Resulting in Impaired Tricuspid Valve Function, Managed with a Valve-Sparing Open Surgical Approach

2021 ◽  
Vol 6 (6) ◽  
Keyword(s):  
Tricuspid Valve ◽  
Surgical Approach ◽  
Lead Extraction ◽  
Pacemaker Lead ◽  
Valve Function ◽  
Symptomatic Bradycardia ◽  
Pacemaker Insertion ◽  
Open Surgical Approach

Retained pacemaker lead fragments can induce fibrosis which can affect valve function. In this case, a female patient in her fifties had undergone pacemaker insertion in her teens for symptomatic bradycardia. Due to pacemaker pocket erosion, she had undergone a lead extraction where lead fragments were left in-situ. Over time, she gradually developed symptomatic tricuspid dysfunction. Due to the severe impact on her quality of life, the patient opted for an open surgical approach. Intraoperatively, electrocautery was used to debride the fibrotic tissue inhibiting the leaflets of the tricuspid valve. This resulted in marked improvement of valve function and additional repair/replacement was not necessary. To our knowledge, such a case has not been previously described.

Traumatic tricuspid valve injury following pacemaker lead extraction: A case report

Sonography ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. 132-135
Author(s):  
Bonita A. Anderson ◽  
Natalie F. Edwards
Keyword(s):  
Case Report ◽  
Tricuspid Valve ◽  
Lead Extraction ◽  
Pacemaker Lead

The Impact of Transvenous Lead Extraction on Tricuspid Valve Function

2013 ◽  
Vol 37 (1) ◽  
pp. 19-24 ◽  
Author(s):  
JAMES O. COFFEY ◽  
SOLOMON J. SAGER ◽  
SANDEEP GANGIREDDY ◽  
AVI LEVINE ◽  
JUAN F. VILES-GONZALEZ ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Lead Extraction ◽  
Valve Function ◽  
The Impact

P3135Tricuspid valve dysfunction caused by transvenous lead extraction. Can we predict this complication?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Polewczyk ◽  
D Nowosielecka ◽  
A Tomaszewski ◽  
W Brzozowski ◽  
D Szczesniak Stanczyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Tricuspid Valve ◽  
Dwell Time ◽  
Lead Extraction ◽  
Function Evaluation ◽  
Main Risk Factor ◽  
Valve Dysfunction ◽  
Valve Function

Abstract Background Accidental damage of tricuspid apparatus is known complication of TLE procedure risk factors of this complication remain unknown. Purpose The goal of this study was to search factors which can predict damage of tricuspid apparatus during TLE. Methods Between 2006 and 2018 we performed 2002 TLE procedures using conventional mechanical sheaths. 3366 leads (mean implant duration 95,2 months) were removed due to non-infective indications in 62,0%. Tricuspid valve function was examined with preoperative and post-operative TTE and during monitoring of procedure. Patients with incomplete TV function evaluation were excluded from the study. Three groups of patients were compared Results TLE procedure brings risk (7%) of different degree damage or tricuspid leflet or even chordae tendinae (2%). The detailed results are presented in the table. Conclusions TLE using conventional mechanical sheaths is effective but brings risk of extraction related tricuspid valve dysfunction. Main risk factor of this complication seems to be implant dwell time, number of leads presence of abandoned leads and lead loop in the heart remaining in conflict with tricuspid valve.

2407Influence of transvenous lead extraction procedure on function of tricuspid apparatus

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Polewczyk ◽  
D Nowosielecka ◽  
A Tomaszewski ◽  
W Brzozowski ◽  
D Szczesniak Stanczyk ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Clinical Success ◽  
Extraction Procedure ◽  
Lead Extraction ◽  
Lead Removal ◽  
Separate Analysis ◽  
Valve Dysfunction ◽  
Valve Function ◽  
Procedural Success

Abstract Background Accidental damage of tricuspid apparatus remain known complication of TLE procedure but our knowledge is limited due lack of separate analysis in the literature. Purpose The goal of this study was analysis of the appearance of lead extraction related tricuspid valve dysfunction using trans-chest and trans-oesophageal echocardiography. Methods Between March 2006 and December 2018 we performed 2900 TLE procedures using conventional mechanical sheaths in 1760 male and 1140 female patients (mean age 66.6y). 4811 leads (mean implant duration 91.5 months) were removed due to non-infective indications in 65.3%. Full radiological success was obtained in 95.7% procedures, partial in 4.0%, clinical success in 98.0%, full procedural success in 96.1%. Major complications (MC) appeared in 8 (1.8%). Results Results are presented in the table Conclusions TLE using conventional mechanical sheaths is effective. Tricuspid valve dysfunction different degree is frequent finding in candidates for TLE. TLE procedure brings risk (7.2%) of different degree damage of tricuspid leflet (significant in 1.5%) or even chordae tendinae (4%). Patients with severe lead extraction related tricuspid valve dysfunction needs exact follow-up and some of them can be candidates for cardiac surgery. On the other hand in not so rare cases of lead related tricuspid valve dysfunction – lead removal/replacement can to bring improvement of tricuspid valve function (6.1%).

scholarly journals Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis

2021 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Anna Polewczyk ◽  
Wojciech Jacheć ◽  
Dorota Nowosielecka ◽  
Andrzej Tomaszewski ◽  
Wojciech Brzozowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tricuspid Valve ◽  
Lead Extraction ◽  
Common Mechanism ◽  
Term Survival ◽  
Long Term Survival ◽  
Valve Dysfunction ◽  
Valve Function ◽  
Long Term Prognosis

Background: Lead-related tricuspid valve dysfunction (LDTVD) has not been studied in a large population and its management remains controversial. Methods: An analysis of the clinical data of 2678 patients undergoing transvenous lead extraction (TLE) in years 2008–2021 was conducted, with a separate group of 119 patients with LDTVD. Potential risk factors for LDTVD, improvement in valve function, and long-term prognosis after TLE were assessed. Results: LDTVD was diagnosed in 4.44% of patients referred for lead extraction due to different reasons. The most common mechanism of LDTVD was propping upward or clamping down the leaflet by the lead (85.71%). The probability of LDTVD was higher in female sex, patients with valvular heart disease, atrial fibrillation, heart failure, large right ventricle and high pulmonary artery systolic pressure, the presence of only pacing lead, and in case of collision of the lead with tricuspid valve and adhesion of the lead to the heart structures. The prognosis of patients with LDTVD was worse, however, patients with improved valve function after TLE showed a significantly better long-term survival. Conclusions: Lead dependent tricuspid valve dysfunction is a potentially serious condition that requires thorough diagnostics and thoughtful management. The risk factors for LDTVD are primarily related to the course of the lead and its adhesion to the heart structures. Improvement of tricuspid valve function after TLE is observed in 35.29% of patients Patients with LDTVD have a worse long-term survival, but the improvement in valve function following TLE contributes to a significant reduction in mortality.

Pengaruh Jenis Co-Solvent terhadap Rendemen dan Mutu Biodiesel secara Transesterifikasi In Situ Menggunakan Radiasi Gelombang Mikro

2016 ◽  
Vol 10 (2) ◽  
pp. 119-126
Author(s):  
Mahlinda Mahlinda ◽  
Fitriana Djafar
Keyword(s):  
Catalyst Concentration ◽  
Maximum Yield ◽  
Acid Value ◽  
Experimental Result ◽  
In Situ Transesterification ◽  
Yield And Quality ◽  
Solvent Type ◽  
Biodiesel Quality

The main purpose of this research was to observer effect co-solvent type (n-Hexane, chloroform and without co-solvent)  toward yield and quality of biodiesel via in situ transesterification process using microwave irradiation. The process was studied at microwave power 450 watt, reaction time 4 minutes, methanol to seed ratio 25:1 and catalyst concentration 5%. The physicochemical parameters of the biodiesel produced such as viscosity, density and acid value were analysed and compared with the SNI 7182-2012 standard. The experimental result showed the maximum yield biodiesel 78,32% obtained by using co-solvent chloroform.Test result of physicochemical properties (viscosity, density and acid value) of biodiesel products using co solvent n-Hexane, chloroform and without co solvent showed that these products conform to the SNI 7182-2012 standars. The type of co-solvent only affectedon biodiesel yield dan not affected on biodiesel quality (viscosity, density and acid value).  ABSTRAKTujuan penelitian ini adalah untuk mempelajari pengaruh jenis co-solvent (n-Hexane, chloroform dan tanpa co-solvent) terhadap rendemen dan mutu biodiesel secara trasesterifikasi in situ menggunakan radiasi gelombang mikro. Proses dilakukan pada daya gelombang mikro 450 watt, waktu reaksi 4 menit, perbandingan berat metanol terhadap bahan baku 25:1 dan jumlah katalis 5%. Parameter fisiko kimia dari produk biodiesel seperti viskositas, densitas dan angka asam di analisa dan dibandingkan dengan standar SNI 7182-2012 tentang biodiesel. Hasil penelitian menunjukkan rendemen maksimum biodiesel sebesar 78,32% diperoleh dengan menggunakan co-solvent chloroform. Hasil pengujian  karakteristik fisiko kimia (viskositas, densitas dan angka asam) dari produk biodiesel menggunakan co-solvent n-Hexane, chloroform dan tanpa co-solvent menunjukkan bahwa semua parameter ini masih memenuhi standar SNI 1782-2012 tentang biodiesel. Jenis co-solvent hanya berpengaruh pada rendemen biodiesel dan tidak berpengaruh terhadap mutu biodiesel (viskositas, densitas dan bilangan asam).Kata kunci: co-solvent, in situ transesterifikasi, microwave, rendemen, mutu   

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