EXTRACTION OF LEAD VIA LEAD WITH DRINKJHG TUBE

摘要

With drinking tube,we extraot peranent pacemaker lead through theleft subclavian route successfully.The following report is a case ofdoing it.A 87-year-old man was admitted to hospital.He had symptom of anginspector is and blackout again and again for six months.His heart ratevaried from forty-four to seventy per minute.ECG showed second degreeartrloventrioular block(Mobiz Ⅱ)and right-bundle branch blockads.This illness was diagnosed as sick sinus syndrome.So he was referredfor placement of a permanent pecewaker(WI)),pacemaker model:Medtrinic8801.On the ninth day,the suboutaneous generator pocket was infected.Two days later,we displaced the pacemker.No consent was obtainedfrom his relatives,we didn’t extract the pacing lead.Although wetried our best.the out remained disunion.After a month,we decided toextract the lead.The operation was performed in a elcetrophyslologylaboratory,we disinfacted the part of the lead exposed to the airand clipped the end.First we made the dilstor sheath(10.5Fr)which fitthe lead packaged with drinking tube(12Fr).So it was easy to push thedrinking tube through the lead.Second,advanced it into the leftautolavian.NOW it was time to pull the dilator sheath(10.5Fr)out.Third,we inserted the stylet which provided additional stiffness andcontrolled flexibililty into the lead.Satisfactory position wasachieved when the stylet was lodged in the spex of right ventriclewhere the lead distal end lay.In other words,imparted the stylet tothe distal end.Tightening the drinking tube with left hand,we rotatedthe lead clockwise with right hand untill the distal and was partedfrog heart eusule,then extracted the lead via vein.There air little previons dootrmen tation about extraction of permanentpacemaker lead with drinking tube and this approach spend less time andless nosey then other methods.Norsover,it has little complication.While,in other methods,a special instrument is essential to extractthe lead.So it’s expensive to do it.The indication of the method withdrinking tube is that the operation should be performed less than threemonths after implantation,no lead fracture was found.The drinkingtube trade mark is Wahaha.Clip the end and grind it,then disinfect itwith othylene oxide.Next step,use it as provided before.