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post #1 of 22 (permalink) Old 08-20-2019, 12:42 PM Thread Starter
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Here's my procedure that's getting done.

Ya. The last paragraph kinda fucks me up.

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Scar tissue envelops chronically implanted leads at discrete sites anywhere along the course through the veins or myocardium, and it behaves as if shrink-wrapped around the leads. Therefore, when trying to pull a lead out, any bulge in the lead has to be dragged through that scar. The electrodes make up for most of the protruding parts, especially the flanges of passive fixation leads. Further, indentations in the lead can be filled with fibrous tissue and resist extraction. The ingrowing of this scar in the defibrillation coils is a major problem when extracting ICD leads. Even when leads dislocate from the myocardium, this often leaves a rim of fibrous tissue around the tip, complicating the extraction even more.

Subsequently, just to be able to make room for the bulky distal part of the lead, it is often necessary to disrupt all proximal scar tissue. To achieve this, a variety of sheaths, mechanical or powered, can be inserted over the lead. However, the superior vena cava has a wall thickness of sometimes less then 1 mm and is vulnerable for damage by the sheaths.6*Sometimes, the path of least resistance is the vessel wall rather than the scar. Disruption of the superior caval or brachiocephalic vein is the most devastating complication of lead extraction, as it results in swift exsanguination in the thoracic cavity and is very difficult for the surgeon to control or repair.7

Damage to the veins can be largely avoided with a femoral approach. With this technique, the leads are first grabbed in the right atrium with a retriever inserted via a sheath introduced through the femoral vein. As the lead body is truly isodiametric, the proximal part of the lead can be often pulled down without excessive force and without a sheath that directly engages the veins. The sheath is, however, still needed to disrupt the scar tissue from the right atrium down to the atrial or ventricular myocardium. Although this still has a risk of perforation, bleeding will be confined to the pericardial space and is more accessible to control by the surgeon.

When should a patient be referred for lead extraction? Generally, leads that are implanted for less than a year can often be removed by traction alone and the risk of the procedure is limited. If too much resistance is encountered, it is safer to abandon the procedure and refer the patient. From time to time, even leads that have been implanted only recently will necessitate tools to extract them. With longer implant times, it is safer if not mandatory to perform lead extraction in the operating room with cardio-surgical standby as there is often not enough time to transfer a patient before irreversible damage has occurred.8*This approach will save a life every 100 or 200 procedures.
The wait in my date is so they have the surgical team ready.
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post #2 of 22 (permalink) Old 08-20-2019, 02:57 PM
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I can understand Your concern John.
Everyone on Our Great Forum is thinking of You.
You are in many of Our Thoughts and Prayers.
Keep a good thought My Brother.
Better Days are Ahead.
Mike U.


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post #3 of 22 (permalink) Old 08-20-2019, 03:00 PM
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Quote:
Originally Posted by Mike U View Post
I can understand Your concern John.
Everyone on Our Great Forum is thinking of You.
You are in many of Our Thoughts and Prayers.
Keep a good thought My Brother.
Better Days are Ahead.
Mike U. Sent from my iPhone using Tapatalk
^^^^^^^^^ THIS ^^^^^^^^
Mike U. said it best. Ditto
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Blessings, Zinc -
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post #4 of 22 (permalink) Old 08-20-2019, 03:06 PM
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I couldn't have stated it any better.

Thought & Prayers Brother.

We are all thinking about you man.

Swomack
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post #5 of 22 (permalink) Old 08-20-2019, 07:13 PM
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I think my "Happy Place" just got hit by a tree? Best of luck on the "cable rerouting" bud, I hope they won't need an extension harness.. Best of luck, Godspeed and I'm reaching out to the "Force" to be with you. See you on the road on your ride soon.
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post #6 of 22 (permalink) Old 08-20-2019, 08:28 PM
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Sending positive thought your way.
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post #7 of 22 (permalink) Old 08-20-2019, 08:39 PM
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Thumbs up

Ditto on Mike Us #2 post above. All the best!
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post #8 of 22 (permalink) Old 08-20-2019, 09:09 PM
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Thoughts and prayers John!!

Keep the faith!
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post #9 of 22 (permalink) Old 08-20-2019, 09:28 PM
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Positive thoughts John. Tough sum bitch.
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post #10 of 22 (permalink) Old 08-20-2019, 09:30 PM
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Please let us know the exact date and time as soon as you know John.

My Dad had a ruptured Aorta about 10 years ago now so he was in his early 70s. He was stabilized by the local hospital in Florida where he was vacationing and I rode down while my brother flew down and we drove him home to Boston to have surgery. (they didn't recommend the pressure change during flight) The doctors planned out the extensive surgical procedure and when they opened him up discovered that he wasn't plumbed the same as everyone else. They were able to perform a successful surgery and he is still with us.

I have had several friends and acquaintances undergo successful heart valve repair surgeries.

It is no fun when you are going through it, but eventually it becomes a distant memory.

Keep positive thoughts, get through the procedure and get back to making the baddest trike on the planet!

Oh, and post more photos of you hottie nurse friend.
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