Thorac Cardiovasc Surg 2023; 71(S 01): S1-S72
DOI: 10.1055/s-0043-1761823
Tuesday, 14 February
Potpourri aus der Thorax-Herz-Gefäß-Chirurgie II

Safety and Efficacy of Laser Lead Extraction in Octo- and Nonagenarians: A Subgroup Analysis from the GALLERY Registry

S. Pecha
1   University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
,
H. Burger
2   Kerckhoff Klinik Bad Nauheim, Bad Nauheim, Deutschland
,
D. U. Chung
3   Asklepios Klinik St. Georg, Hamburg, Deutschland
,
V. Möller
4   Immanuel Herzzentrum Brandenburg, Bernau bei Berlin, Deutschland
,
T. Madej
5   University Hospital Carl Gustav Carus Dresden Heart Center, Dresden, Deutschland
,
A. Maali
6   Herzzentrum, Coswig (Anhalt), Deutschland
,
B. Osswald
7   Johanniter-Krankenhaus Duisburg-Rheinhausen, Duisburg, Deutschland
,
R. De Simone
8   Universitätsklinikum Heidelberg Klinik für Herzchirurgie, Heidelberg, Deutschland
,
N. Monsefi
9   Helios Klinikum Siegburg, Siegburg, Deutschland
,
V. Ziaukas
10   Schüchtermann-Klinik, Bad Rothenfelde, Deutschland
,
S. Erler
11   Department of Cardiothoracic Surgery, Bad Bevensen, Deutschland
,
M. Perthel
12   Heart Centre Bad Segeberg, Bad Segeberg, Deutschland
,
M. S. Wehbe
13   Sana Herzchirurgie Stuttgart GmbH, Stuttgart, Deutschland
,
N. Ghaffari
14   Helios Heart Surgery Clinic Karlsruhe, Karlsruhe, Deutschland
,
T. Sandhaus
15   Erlanger Allee 101, Jena, Deutschland
,
H. Busk
16   Uniklinik Magdeburg, Magdeburg, Deutschland
,
J. D. Schmitto
17   Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
,
V. Bärsch
18   St. Marien-Krankenhaus Siegen—Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Siegen, Deutschland
,
J. Easo
19   Hospital Oldenburg, Oldenburg, Deutschland
,
M. Albert
20   Robert-Bosch Hospital, Stuttgart, Deutschland
,
H. Treede
21   Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
,
H. Nägele
22   Albertinen Krankenhaus, Hamburg, Deutschland
,
D. Zenker
23   Robert-Koch-Str. 40, Göttingen, Deutschland
,
Y. Hegazy
24   MediClin Heart Center Lahr/Baden, Lahr/Schwarzwald, Deutschland
,
N. Gessler
3   Asklepios Klinik St. Georg, Hamburg, Deutschland
,
M. Knaut
25   Herzzentrum Dresden Universitätsklinik, Herzchirurgie, Dresden, Deutschland
,
H. Reichenspurner
1   University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
,
S. Willems
3   Asklepios Klinik St. Georg, Hamburg, Deutschland
,
C. Butter
4   Immanuel Herzzentrum Brandenburg, Bernau bei Berlin, Deutschland
,
S. Hakmi
3   Asklepios Klinik St. Georg, Hamburg, Deutschland
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Background: In an aging population with cardiac implantable electronic devices (CIED), an increasing number of octogenarians and even nonagenarians present for lead extraction procedures. Those patients are considered as having an increased risk for surgical procedures including lead extraction. We here investigated in a large patient cohort safety and efficacy of transvenous lead extraction with powered extraction sheaths in octo- and nonagenarians.

Method: A subgroup analysis of the German Laser Lead Extraction Registry (GALLERY) registry was performed. A total of 499 patients aged ≥80 years were included in this analysis. Primary extraction method was Laser lead extraction, with additional use of mechanical rotational sheaths or femoral snares, if necessary. Predictors for complications and mortality were evaluated in multivariate analysis.

Results: Mean patients age was 84.3 ± 3.7 years, 27.1% were female. A total of 1,196 leads were treated. The median lead dwell time was 118.0 (78; 167) months. Clinical procedural success rate was achieved in 97.6% of the cases. Procedural failure was observed in 2.1%. Overall complication rate was 4.4%, including 1.8% major and 2.6% minor complications. BMI < 20 was the only statistically significant predictor for procedure related complications. Procedure-related mortality was 0.8%, and all-cause in-hospital mortality was 5.4%. Predictors for in-hospital mortality were systemic infection, BMI ≤20 kg/m2, procedural complications and chronic kidney disease.

Conclusion: Laser lead extraction in octo- and nonagenarians is safe and effective. BMI ≤20 kg/m2 was the only statistically significant predictor for procedural complications. According to our data, advanced age should not be considered as contraindication for laser lead extraction.



Publication History

Article published online:
28 January 2023

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