The GermAn Laser Lead Extraction RegistrY: GALLERY

Author:

Pecha Simon1ORCID,Burger Heiko2ORCID,Chung Da Un3ORCID,Möller Viviane4ORCID,Madej Tomas5,Maali Alaa6ORCID,Osswald Brigitte7,De Simone Raffaele8,Monsefi Nadeja9,Ziaukas Virgilijus10,Erler Stefan11,Elfarra Hamdi12,Perthel Mathias13,Wehbe Mahmoud S10,Ghaffari Naser14,Sandhaus Tim15,Busk Henning16,Schmitto Jan D17,Bärsch Volker18,Easo Jerry19ORCID,Albert Marc20ORCID,Treede Hendrik21,Nägele Herbert22ORCID,Zenker Dieter23,Hegazy Yasser24,Ahmadi Donja1ORCID,Gessler Nele3ORCID,Ehrlich Wolfgang2,Romano Gabriele8ORCID,Knaut Michael5,Reichenspurner Hermann1,Willems Stephan3ORCID,Butter Christian4,Hakmi Samer3

Affiliation:

1. Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, University Hospital Eppendorf , Martinistr. 52, 20246 Hamburg , Germany

2. Department of Cardiac Surgery, Kerckhoff-Klinik , Bad Nauheim , Germany

3. Department of Cardiology and Critical Care Medicine, Asklepios Klinik St Georg , Hamburg , Germany

4. Department of Cardiology, Heart Center Brandenburg and Brandenburg Medical School , Bernau , Germany

5. Department of Cardiac Surgery, University Heart Center Dresden , Dresden , Germany

6. Department of Cardiovascular Surgery, MediClin Heart Center , Coswig , Germany

7. Division of Electrophysiological Surgery, Johanniter-Hospital Duisburg-Rheinhausen , Duisburg , Germany

8. Department of Cardiac Surgery, Heidelberg University Hospital , Heidelberg , Germany

9. Department of Cardiac Surgery, University Hospital Bonn , Bonn , Germany

10. Department of Cardiac Surgery, Schüchtermann-Klinik , Bad Rothenfelde , Germany

11. Department for Cardiothoracic Surgery, Heart and Vessel Center Bad Bevensen , Bad Bevensen , Germany

12. Department for Cardiovascular Surgery, Hospital of the Philipps-University of Marburg , Marburg , Germany

13. Department of Cardiac Surgery, Heart Center Bad Segeberg , Bad Segeberg , Germany

14. Department of Cardiovascular Surgery, Helios Clinic for Heart Surgery , Karlsruhe , Germany

15. Department of Cardiothoracic Surgery, University Hospital Jena , Jena , Germany

16. Division of Cardiothoracic Surgery, University Hospital of Magdeburg , Magdeburg , Germany

17. Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School , Hannover , Germany

18. Department of Cardiology, St Marien Hospital , Siegen , Germany

19. Department of Cardiac Surgery, University Hospital Essen , Essen , Germany

20. Department of Cardiac Surgery, Robert-Bosch Hospital , Stuttgart , Germany

21. Department of Cardiothoracic and Vascular Surgery, University Hospital Mainz , Mainz , Germany

22. Department for Cardiac Insufficiency and Device Therapy, Albertinen-Hospital , Hamburg , Germany

23. Department of Thoracic and Cardiovascular Surgery, Georg August University Medical Center , Göttingen , Germany

24. Department of Cardiac Surgery, MediClin Heart Institute , Lahr/Baden , Germany

Abstract

Abstract Aims The GermAn Laser Lead Extraction RegistrY: GALLERY is a retrospective, national multicentre registry, investigating the safety and efficacy of laser lead extraction procedures in Germany. Methods and results Twenty-four German centres that are performing laser lead extraction have participated in the registry. All patients, treated with a laser lead extraction procedure between January 2013 and March 2017, were consecutively enrolled. Safety and efficacy of laser lead extraction were investigated. A total number of 2524 consecutive patients with 6117 leads were included into the registry. 5499 leads with a median lead dwell time of 96 (62–141) months were treated. The mean number of treated leads per patient was 2.18 ± 1.02. The clinical procedural success rate was 97.86% and the complete lead removal was observed in 94.85%. Additional extraction tools were used in 6.65% of cases. The rate of procedural failure was 2.14% with lead age  ≥10 years being its only predictor. The overall complication rate was 4.32%, including 2.06% major and 2.26% minor complications. Procedure-related mortality was 0.55%. Female sex and the presence of abandoned leads were predictors for procedure-related complications. The all-cause in-hospital mortality was 3.56% with systemic infection being the strongest predictor, followed by age ≥75 years and chronic kidney disease. Conclusion In the GALLERY, a high success- and low procedure-related complication rates have been demonstrated. In multivariate analysis, female sex and the presence of abandoned leads were predictors for procedure-related complications, while the presence of systemic infection, age ≥75 years, and chronic kidney disease were independent predictors for all-cause mortality.

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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