Archives of the Turkish Society of Cardiology
Extraction of a large vegetation and ICD lead using the Evolution Mechanical Dilator Sheath [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(5): 403-406 | DOI: 10.5543/tkda.2011.01356

Extraction of a large vegetation and ICD lead using the Evolution Mechanical Dilator Sheath

Tolga Aksu, Mine Durukan, Umit Guray, Ayse Colak
Ankara Yuksek Ihtisas Education And Research Hospital, Department of Cardiology, Ankara, Turkey

A 74-year-old male patient presented with complaints of fatigue, fever, and worsening health status. He had a 34-month history of cardioverter-defibrillator (ICD) implantation due to ischemic cardiomyopathy. Transthoracic and transesophageal echocardiography showed a mobile mass, 24x11 mm in size, consistent with a vegetation attached to the right ventricular ICD lead. Surgical removal of the electrode was considered to be highly risky for the patient, thus percutaneous removal was decided. Due to adhesions, manual traction of the lead with a standard stylet was ineffective. Complete lead extraction was accomplished using the Evolution Mechanical Dilator Sheath, which is a new mechanical sheath with a stainless steel bladed tip. No complications occurred during or after the procedure. Following a histopathologic diagnosis of vegetation, the patient received a six-week antibiotic therapy, after which a new ICD was implanted on the contralateral side. To our knowledge, this case represents the largest lead vegetation extracted by this new device. Although its safety should be validated by increasing number of cases, it seems that its simple use would make this device a new interesting tool among the instruments available for lead extraction.

Keywords: Bacterial infections/complications, device removal/methods, electrodes, implanted; pacemaker, artificial

How to cite this article
Tolga Aksu, Mine Durukan, Umit Guray, Ayse Colak. Extraction of a large vegetation and ICD lead using the Evolution Mechanical Dilator Sheath. Turk Kardiyol Dern Ars. 2011; 39(5): 403-406

Corresponding Author: Tolga Aksu, Türkiye
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