Visual abstract – Supplemental material for Anterior Pathway for Epicardial Left Atrial Appendage Clip Occlusion During Minimally Invasive Atrioventricular Valve Surgery

Supplemental material, sj-pptx-1-inv-10.1177_15569845221137886 for Anterior Pathway for Epicardial Left Atrial Appendage Clip Occlusion During Minimally Invasive Atrioventricular Valve Surgery by Maximilian Vondran, Frank Rose, Hendrik Treede, Andreas Liebold, Nicolas Doll, Yeong-Hoon Choi and Alexander Kaminski in Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery</p

Patients’ characteristics.

Patients’ characteristics.</p

Leads and removal outcomes.

Leads and removal outcomes.</p

The Attain Starfix active fixation extraction mechanism.

The Attain Starfix active fixation extraction mechanism.</p

Coronary Sinus Lead Removal: A Comparison between Active and Passive Fixation Leads

<div><p>Background</p><p>Implantation of coronary sinus (CS) leads may be a difficult procedure due to different vein anatomies and a possible lead dislodgement. The mode of CS lead fixation has changed and developed in recent years.</p><p>Objectives</p><p>We compared the removal procedures of active and passive fixation leads.</p><p>Methods</p><p>Between January 2009 and January 2014, 22 patients at our centre underwent CS lead removal, 6 active and 16 passive fixation leads were attempted using simple traction or lead locking devices with or without laser extraction sheaths. Data on procedural variables and success rates were collected and retrospectively analyzed.</p><p>Results</p><p>The mean patient age was 67.2 ± 9.8 years, and 90.9% were male. The indication for lead removal was infection in all cases. All active fixation leads were Medtronic^® Attain StarFix^™ Model 4195 (Medtronic Inc., Minneapolis, MN, USA). The mean time from implantation for the active and passive fixation leads was 9.9 ± 11.7 months (range 1.0–30.1) and 48.7 ± 33.6 months (range 5.7–106.4), respectively (p = 0.012). Only 3 of 6 StarFix leads were successfully removed (50%) compared to 16 of 16 (100%) of the passive fixation CS leads (p = 0.013). No death or complications occurred during the 30-day follow-up.</p><p>Conclusion</p><p>According to our experience, removal of the Starfix active fixation CS leads had a higher procedural failure rate compared to passive.</p></div

Chest-X-Ray with abandoned LV Lead fragment after extraction failure.

<p>Chest-X-Ray with abandoned LV Lead fragment after extraction failure.</p

Re-implantation status.

<p>Re-implantation status.</p