Description of Event or Problem · 1
THIS WAS A LEAD EXTRACTION CASE TO REMOVAL ONE MDT 6949 LEAD. PHYSICIAN BEGAN WITH A 14F GLIDELIGHT AND VISISHEATH. THE PHYSICIAN MET VERY TOUGH BINDING AT THE PROXIMAL END OF THE SVC COIL AND COULD NOT ADVANCE THE VISISHEATH. THE 14F GLIDELIGHT WAS UPSIZED TO A 16F GLIDELIGHT, ALSO WITH A VISISHEATH, BUT MET THE SAME BARRIER. PHYSICIAN WAS USING HIGH FORCE TO TRY TO GET OVER THE BINDING SITE. A DROP IN BLOOD PRESSURE WAS NOTICED AND THE PHYSICIAN IDENTIFIED AN EFFUSION AT THE APEX. A PERICARDIOCENTESIS WAS PERFORMED AND 500CC OF BLOODY FLUID WAS REMOVED FROM THE PERICARDIAL SAC. CT SURGEON INTERVENED, CREATED A WINDOW, AND FOUND A SMALL SVC TEAR THAT HAD CLOTTED ITSELF OFF. THE CT THEN PERFORMED A STERNOTOMY AND IDENTIFIED A TEAR IN THE MID-SVC NEAR THE AZYGOS VEIN, WHICH WAS REPAIRED. THE LEAD WAS CAPPED AND ABANDONED INSIDE THE PATIENT. PATIENT IS CURRENTLY STABLE AND RESPONDING WITH POSITIVE HOPES FOR RECOVERY. PHYSICIAN FEELS HE CREATED THE HOLE WITH THE 14F GLIDELIGHT, AND THEN THE HOLE BECAME ENLARGED WITH THE 16F GLIDELIGHT, BASED ON CAPTURED REVIEW OF FLUORO.