P1504Monitoring of TLE procedure using TEE practical utility Experience from 927 procedures

Abstract

Abstract Background Monitoring of the process of transvenous lead extraction using continuous TEE was delivered for the purpose of earlier recognition of cardiac or venuos wall tear (behind hemodynamic and respiratory monitoring etc). But our experience indicates that it may be providing much more very important information for operator about present occurrences invisible for fluoroscopy monitoring and to warm about threatening disaster. Objective The goal of this study was to describe frequency of menaces visible in TEE before after effects will reveal. Methods During last 4,5 years 1019 TLE were performed but due to different reasons complete TEE monitoring was performed in 910 patients; 1705 leads (1-4 leads, aver 1,66, with mean implant duration 100,7 mth) were extracted using as first line non-powered mechanical tools. There were 20 major complications (2,0%) but no procedure related death. We obtained 98,7% procedural and 97,9% clinical success. Results are presented in the table. Conclusions TEE cautioned about dangerous poling or torsion of the heart structures and permitted immediate explanation of the reasons of drop of blood pressure, brought information about arising cardiac tamponade, about rapid blood clothing in epicardial space and the onset of cave-in RV wall before significant drop of blood pressure. Uncomplicated course after rescue sternotomy seems be result of timeous it execution. Abstract Figure.