International Journal of Cardiology 185 (2015) 214–217
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Transvenous recovery of an intracardiac fractured port-A catheter fragment Giuseppe Mario Calvagna a,⁎, Salvatore Patanè a, Placido Romeo b, Sonja Condorelli c, Ludovico Vasquez a,d a
Cardiologia Ospedale San Vincenzo — Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy Radiologia Ospedale San Vincenzo — Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy UOC Oncologia Presidio di Caltagirone, Azienda Sanitaria Provinciale di Catania, Italy d Cardiologia Presidio Ospedaliero “G. Fogliani” — Milazzo (ME), Azienda Sanitaria Provinciale di Messina, Italy b c
a r t i c l e
i n f o
Article history: Received 3 February 2015 Accepted 7 March 2015 Available online 10 March 2015 Keywords: Cardiac devices Chemotherapy Endocarditis Infections Port-A catheter Transvenous lead extraction
The optimal management of implanted devices has become a serious worldwide challenge and many techniques for addressing device complications have been developed including endovascular retrieval of lost or misplaced fractured foreign objects [1]. The use of implantable cardiac devices has increased in the last 30 years [1–46]. Infectious complications leading to endocarditis [2,6,8,28–36] and noninfectious complications [9,21,23,37–40] often necessitating removal [1,2,8,40–46] have affected patients' wellbeing and have also led to an increase in psychological difficulties [47–53]. This emerging scenario of concomitant problems and diseases [54–81] also includes patients needing device revision and upgrade. In addition, improved patients' survival, a progressively younger implanted population and the increase in device and procedure complexity have raised the risk of system component structural failures [82–87]. For these reasons, the necessity of extraction has become increasingly higher and the development of specific techniques and tools to reduce morbidity and mortality associated with the removal of pacing devices has played an important role representing the cornerstone of modern clinical cardiac electrophysiology as well as efficacious implantation and management of cardiac devices. A mechanical technique (transvenous lead extraction) is an effective ⁎ Corresponding author at: Cardiologia Ospedale San Vincenzo — Taormina (Me), Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039 Taormina, Messina, Italy. E-mail address: [email protected] (G.M. Calvagna).
http://dx.doi.org/10.1016/j.ijcard.2015.03.087 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
technique with few complications, but the collaborative vision of a multi-disciplinary treatment team [53,72] is required for the patient's safety and complete rehabilitation [82–88]. The safety and effectiveness of transvenous lead extraction has also been demonstrated for difficult dialysis catheter [89] and port catheter removal [76]. The difficult extraction of dialysis catheters due to a hard fibrin sheath along their course and spontaneous fracture and migration of implanted port catheters are emerging common drawbacks [76,89] as well as the retrieval and removal of foreign intravascular bodies to prevent cardiovascular complications. We present the case of a 40-year-old Italian woman with a history of an implanted right subclavian port-A catheter in 2012 for colorectal adenocarcinoma chemotherapy. Chest X-ray examination revealed the presence of a spontaneous fracture and embolization and migration of a fixed fragment with a size of about 10 cm placed between the right atrium and right ventricle across the tricuspid valve (Fig. 1 panels A and B). We successfully performed the recovery of the fragment from the right femoral venous access through Seldinger's technique with a TIP Deflecting Wire Guide (Cook Vascolar) used for moving it and a recovery loop AndraSnare AS-25 (125 cm; 5 Fr; Andramed model) used for its capture (Fig. 2). Also this case focuses on the safety and effectiveness of transvenous lead extraction and it is illustrative of its use as a new challenge in cardiology. Author contributions Salvatore Patanè wrote the work. Giuseppe Mario Calvagna prepared the references and performed the fragment recovery. Sonja Condorelli prepared Fig. 1. Placido Romeo prepared Fig. 2. Ludovico Vasquez prepared the legends for Figs. 1 and 2. Conflict of interest The authors report no relationships that could be construed as a conflict of interest. Acknowledgments The authors of this manuscript have certified that they adhere to the statement of ethical publishing as appears in the International Journal of Cardiology.
G.M. Calvagna et al. / International Journal of Cardiology 185 (2015) 214–217
215
Fig. 1. (Panels A and B). Chest X-ray examination revealed the presence of a spontaneous fracture and embolization and migration of a fixed fragment with a size of about 10 cm placed between the right atrium and right ventricle across the tricuspid valve.
[8]
[9]
[10]
[11]
[12]
[13] Fig. 2. The fragment recovery performed successfully from the right femoral venous access through Seldinger's technique with a TIP Deflecting Wire Guide (Cook Vascolar) used for moving it and a recovery loop AndraSnare AS-25 (125 cm; 5 Fr; Andramed model) used for its capture.
[14]
[15]
[16]
References [1] G.M. Calvagna, P. Romeo, F. Ceresa, S. Valsecchi, Transvenous retrieval of foreign objects lost during cardiac device implantation or revision: a 10-year experience, Pacing Clin. Electrophysiol. 36 (7) (Jul 2013) 892–897. [2] G.M. Calvagna, S. Patanè, Severe staphylococcal sepsis in patient with permanent pacemaker, Int. J. Cardiol. 172 (3) (Apr 1 2014) e498–e501. [3] C. Ward, S. Henderson, N.H. Metcalfe, A short history on pacemakers, Int. J. Cardiol. 169 (4) (Nov 15 2013) 244–248. [4] K. Toutouzas, A. Synetos, D. Tousoulis, G. Latsios, S. Brili, A. Mastrokostopoulos, A. Karanasos, S. Sideris, P. Dilaveris, A. Cheong, C.M. Yu, C. Stefanadis, Predictors for permanent pacemaker implantation after core valve implantation in patients without preexisting ECG conduction disturbances: the role of a new echocardiographic index, Int. J. Cardiol. 172 (3) (Apr 1 2014) 601–603. [5] V. Giugno, F. Messina, S. Crosca, Treatment failure of low molecular weight heparin bridging therapy after implantation of a permanent pacemaker, Int. J. Cardiol. 173 (3) (May 15 2014) e23–e24. [6] J.A. Sandoe, G. Barlow, J.B. Chambers, M. Gammage, A. Guleri, P. Howard, E. Olson, J.D. Perry, B.D. Prendergast, M.J. Spry, R.P. Steeds, M.H. Tayebjee, R. Watkin, Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE), J. Antimicrob. Chemother. 70 (2) (Feb 2015) 325–359. [7] Y. Aizawa, S. Takatsuki, M. Negishi, S. Kashimura, Y. Katsumata, T. Nishiyama, T. Kimura, N. Nishiyama, Y. Tanimoto, K. Tanimoto, S. Kohsaka, M. Sano, K. Fukuda,
[17]
[18]
[19] [20]
[21]
[22]
[23] [24]
Clinical characteristics of atrial fibrillation detected by implanted devices and its association with ICD therapy, Int. J. Cardiol. 172 (3) (Apr 1 2014) e529–e530. M. Scarano, F. Pezzuoli, G. Torrisi, G.M. Calvagna, S. Patanè, Cardiovascular implantable electronic devices infective endocarditis, Int. J. Cardiol. 173 (3) (May 15 2014) e38–e39. S. Ahmed, P. Ungprasert, N. Srivali, S. Ratanapo, W. Cheungpasitporn, D. Chongnarungsin, Lead perforation: an uncommon cause of chest pain in a patient with pacemaker, Int. J. Cardiol. 167 (5) (Sep 1 2013) e113–e114. K.P. Van Galen, J. van Dijk, J.C. Regelink, P.C. Huijgens, M.C. Minnema, S. Zweegman, Implantable defibrillators in cardiac amyloidosis, Int. J. Cardiol. 165 (2) (May 10 2013) 371–373. F. Fang, Q. Zhang, J.Y. Chan, O. Razali, H. Azlan, H.C. Chan, J.E. Sanderson, J.M. Xie, C.M. Yu, Early pacing-induced systolic dyssynchrony is a strong predictor of left ventricular adverse remodeling: analysis from the Pacing to Avoid Cardiac Enlargement (PACE) trial, Int. J. Cardiol. 168 (2) (Sep 30 2013) 723–728. A. Sairaku, Y. Yoshida, Y. Nakano, Y. Kihara, Ablation of atrial fibrillation in Brugada syndrome patients with an implantable cardioverter defibrillator to prevent inappropriate shocks resulting from rapid atrial fibrillation, Int. J. Cardiol. 168 (6) (Oct 15 2013) 5273–5276. F. Fang, J.Y. Chan, A.P. Lee, S.H. Sung, X.X. Luo, X. Jiang, J.S. Kwong, J.E. Sanderson, C.M. Yu, Improved coronary artery blood flow following the correction of systolic dyssynchrony with cardiac resynchronization therapy, Int. J. Cardiol. 167 (5) (Sep 1 2013) 2167–2171. Z. Cheng, H. Deng, K. Cheng, T. Chen, P. Gao, Q. Fang, Implantation of a pacemaker in a patient with persistent left superior vena cava and absence of right superior vena cava, Int. J. Cardiol. 168 (2) (Sep 30 2013) e53–e54. C. Schukro, L. Leitner, J. Siebermair, T. Pezawas, G. Stix, J. Kastner, H. Schmidinger, Impact of accelerated ventricular tachyarrhythmias on mortality in patients with implantable cardioverter-defibrillator therapy, Int. J. Cardiol. 167 (6) (Sep 10 2013) 3006–3010. K.A. Gatzoulis, D. Tsiachris, P. Dilaveris, S. Archontakis, P. Arsenos, A. Vouliotis, S. Sideris, G. Trantalis, E. Kartsagoulis, I. Kallikazaros, C. Stefanadis, Implantable cardioverter defibrillator therapy activation for high risk patients with relatively well preserved left ventricular ejection fraction. Does it really work? Int. J. Cardiol. 167 (4) (Aug 20 2013) 1360–1365. M. Peyrol, P. Sbragia, B. Obadia, M. Laine, C. Villacampa, S. Armero, L. Bonello, J. Pinto, F. Thuny, F. Paganelli, The safety of cardiac resynchronization therapy pacemaker implantation in octogenarians: a monocentric experience, Int. J. Cardiol. 168 (3) (Oct 3 2013) 2969–2970. R. Sankaranarayanan, R. Visweswariah, D.J. Fox, New developments in cardiac resynchronization therapy, Br. J. Hosp. Med. (Lond.) 74 (9) (Sep 2013) 503–509. S. Patanè, Paced patient and acute myocardial infarction, Int. J. Cardiol. 161 (1) (Nov 1 2012) e16–e17. J. Veselka, J. Krejčí, P. Tomašov, V. Durdil, L. Riedlbauchová, J. Honěk, T. Honěk, D. Zemánek, Outcome of patients after alcohol septal ablation with permanent pacemaker implanted for periprocedural complete heart block, J. Cardiol. Int. 171 (2) (Feb 1 2014) e37–e38. R. La Rocca, V. Materia, M.F. Falliano, N. Sciacca, F. Marte, S. Patanè, Hyperkalaemic cardiac arrhythmia with pacemaker/implantable cardioverter-defibrillator action disturbance, Int. J. Cardiol. 156 (3) (May 3 2012) e49–e50. E.O. Udo, N.M. van Hemel, N.P. Zuithoff, H. Nijboer, W. Taks, P.A. Doevendans, K.G. Moons, Long term quality-of-life in patients with bradycardia pacemaker implantation, Int. J. Cardiol. 168 (3) (Oct 3 2013) 2159–2163. G.M. Calvagna, F. Ceresa, S. Patanè, Subcutaneous implantable cardioverterdefibrillator in a young woman, Int. J. Cardiol. 175 (2) (Aug 1 2014) e30–e32. F. Reinke, A. Löher, J. Köbe, L. Eckardt, Current status and problems of the entirely subcutaneous ICD (S-ICD®), Herzschrittmacherther. Elektrophysiol. 24 (3) (Sep 2013) 165–170 (German).
216
G.M. Calvagna et al. / International Journal of Cardiology 185 (2015) 214–217
[25] S. Aziz, A.R. Leon, M.F. El-Chami, The subcutaneous defibrillator—a review of the literature, J. Am. Coll. Cardiol. 63 (15) (Apr 22 2014) 1473–1479. [26] P.D. Lambiase, C. Barr, D.A. Theuns, R. Knops, P. Neuzil, J.B. Johansen, M. Hood, S. Pedersen, S. Kääb, F. Murgatroyd, H.L. Reeve, N. Carter, L. Boersma, on behalf of the EFFORTLESS Investigators, Worldwide experience with a totally subcutaneous implantable defibrillator: early results from the EFFORTLESS S-ICD Registry, Eur. Heart J. 35 (25) (Jul 1 2014) 1657–1665. [27] F. Akerström, M.A. Arias, M. Pachón, A. Puchol, J. Jiménez-López, Subcutaneous implantable defibrillator: state-of-the art 2013, World J. Cardiol. 5 (9) (Sep 26 2013) 347–354. [28] G.M. Calvagna, Recall, malfunzionamenti e infezioni in portatori di PM/ICD. Possono condizionare le scelte clinico-interventistiche e la qualità della vita? GIAC 13 (3–4) (2010) 217–222. [29] M. Scarano, F. Pezzuoli, S. Patanè, Brucella infective endocarditis, Int. J. Cardiol. 172 (3) (Apr 1 2014) e509–e510. [30] S. Patanè, Is there a need for bacterial endocarditis prophylaxis in patients undergoing urological procedures? J. Cardiovasc. Transl. Res. 7 (3) (Apr 2014) 369–371. [31] S. Patanè, Is there a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy? J. Cardiovasc. Transl. Res. 7 (3) (Apr 2014) 372–374. [32] G.M. Calvagna, Progressivo malfunzionamento di elettrocatetere da stimolazione cardiaca permanente secondario a processo infettivo asintomatico, GIAC 15 (1) (2012) 51–54. [33] G.M. Calvagna, S. Curatolo, S. La Greca, R. Evola, Sepsi Stafilococciche in pazienti portatori di PM e\o ICD: Dal trattamento antibiotico all'intervento di Rimozione Transvenosa Manuale, G. It. Aritmol. Cardiostim 13 (1) (Marzo 2010). [34] S. Patanè, A dark side of the cardio-oncology: the bacterial endocarditis prophylaxis, Int. J. Cardiol. 157 (3) (Jun 14 2012) 448–449. [35] G.M. Calvagna, A. Mangano, R. Evola, Infezioni su estremita' distali degli elettrocateteri da stimolazione cardiaca permanente rimossi mediante tecnica transvenosa manuale: casistica dal 2002 al 2007 presso centro unico dedicato, G. Ital. Aritmol. Cardiostim 4 (2008) 65–68. [36] G.M. Calvagna, S. Patanè, Transvenous pacemaker lead extraction in infective endocarditis, Int. J. Cardiol. 176 (2) (Sep 20 2014) 511–513. [37] M. Imazio, B.D. Hoit, Post-cardiac injury syndromes. An emerging cause of pericardial diseases, Int. J. Cardiol. 168 (2) (Sep 30 2013) 648–652. [38] A. Chikata, W. Omi, T. Saeki, H. Nagai, S. Sakagami, Repeated pacemaker dysfunction in a patient with recurrent takotsubo cardiomyopathy precipitated by hyponatremia, Int. J. Cardiol. 170 (3) (Jan 1 2014) 443–444. [39] H. Kawata, J. Patel, T. McGarry, R. Joshi, D. Krummen, G. Feld, U. Birgersdotter-Green, Obese female patients have higher rates of lead dislodgement after ICD or CRT-D implantation, Int. J. Cardiol. 172 (3) (Apr 1 2014) e522–e524. [40] G.M. Calvagna, R. Evola, Complicanze non infettive o malfunzionamenti in pazienti portatori di PM e/o ICD: importanza della rimozione transvenosa, G. Ital. Aritmol. Cardiostim 12 (2) (2009) 69–78. [41] G.M. Calvagna, S. Patanè, P. Romeo, F. Ceresa, F. Sansone, F. Patanè, Embolization and retrieval of an anchoring sleeve during transvenous lead extraction, Int. J. Cardiol. 173 (3) (May 15 2014) e42–e44. [42] G.M. Calvagna, R. Foti, M. Lisi, R. Evola, Rimozione transvenosa manuale di elettrocateteri da Pacemaker e\o ICD malfunzionanti o infetti mediante tecnica transvenosa manuale: Esperienza di unico centro regionale dedicato (anni 2002– 2007), G. It. Aritmol. Cadiostim 4 (2007) 30–35. [43] G.M. Calvagna, R. Evola, G. Scardace, S. Valsecchi, Single-operator experience with a mechanical approach for removal of pacing and implantable defibrillator leads, Europace 11 (11) (Nov 2009) 1505–1509. [44] G.M. Calvagna, R. Evola, G. Scardace, S. Valsecchi, Successful removal of a jugular implantable defibrillator lead with mechanical single-sheath technique, Pacing Clin. Electrophysiol. 35 (9) (Sep 2012) e258–e260. [45] G.M. Calvagna, R. Evola, S. Valsecchi, A complication of pacemaker lead extraction: pulmonary embolization of an electrode fragment, Europace 12 (2010) 613. [46] P. Kumar, J.D. Schwartz, Device therapies: new indications and future directions, Curr. Cardiol. Rev. 11 (1) (2015) 33–41. [47] S.S. Pedersen, M.T. Hoogwegt, L. Jordaens, D.A. Theuns, Procedure- and devicerelated complications and psychological morbidity in implantable cardioverter defibrillator patients, Int. J. Cardiol. 168 (1) (Sep 20 2013) 606–607. [48] M. Feola, P. Vallauri, L. Salvatico, A. Vado, M. Testa, Neuropsychological impact of implantable cardioverter defibrillator in congestive heart failure patients, Int. J. Cardiol. 166 (1) (Jun 5 2013) 275–276. [49] J. Denollet, F.B. Tekle, S.S. Pedersen, P.H. van der Voort, M. Alings, K.C. van den Broek, Prognostic importance of distressed (Type D) personality and shocks in patients with an implantable cardioverter defibrillator, Int. J. Cardiol. 167 (6) (Sep 10 2013) 2705–2709. [50] S.S. Pedersen, M.T. Hoogwegt, L. Jordaens, D.A. Theuns, Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation, Int. J. Cardiol. 166 (1) (Jun 5 2013) 215–220. [51] J. Ingles, T. Sarina, N. Kasparian, C. Semsarian, Psychological wellbeing and posttraumatic stress associated with implantable cardioverter defibrillator therapy in young adults with genetic heart disease, Int. J. Cardiol. 168 (4) (Oct 9 2013) 3779–3784. [52] K.C. van den Broek, F.B. Tekle, M. Habibović, M. Alings, P.H. van der Voort, J. Denollet, Emotional distress, positive affect, and mortality in patients with an implantable cardioverter defibrillator, Int. J. Cardiol. 165 (2) (May 10 2013) 327–332.
[53] G.M. Calvagna, G. Torrisi, C. Giuffrida, S. Patanè, Pacemaker, implantable cardioverter defibrillator, CRT, CRT-D, psychological difficulties and quality of life, Int. J. Cardiol. 174 (2) (Jun 15 2014) 378–380. [54] P. Pugliatti, R. Donato, G. Di Bella, S. Carerj, S. Patanè, Contrast-enhancing right atrial thrombus in cancer patient, Int. J. Cardiol. 173 (3) (May 15 2014) e35–e37. [55] P. Pugliatti, R. Donato, C. Zito, S. Carerj, S. Patanè, Cardioinhibitory vasovagal syncope in a cancer patient, Int. J. Cardiol. 174 (2) (Jun 15 2014) e64–e65. [56] S. Patanè, Cardiotoxicity: cisplatin and long term cancer survivors, Int. J. Cardiol. 175 (1) (Jul 15 2014) 201–202. [57] S. Patanè, A challenge in cardiology: the oncosurgery, Int. J. Cardiol. 174 (2) (Jun 15 2014) 411–412. http://dx.doi.org/10.1016/j.ijcard.2014.04.046 (Epub 2014 Apr 13). [58] S. Patanè, Heart failure and breast cancer: emerging controversies regarding some cardioprotective strategies, J. Card. Fail. 20 (6) (Jun 2014) 456–457. [59] S. Patanè, Insights into cardio-oncology: adrenergic receptor signaling and pathways in breast cancer, Curr. Med. Res. Opin. (Jun 26 2014) 1–2. [60] S. Patanè, Breast cancer treatment cardioprotective strategies: the King is naked, J. Am. Heart Assoc. (2014) (Published July 22,2014 http://www.jaha.ahajournals.org/content/ 3/2/e000665/reply). [61] S. Patanè, ERBB1/EGFR and ERBB2 (HER2/neu) — targeted therapies in cancer and cardiovascular system with cardiovascular drugs, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1301–1303. [62] S. Patanè, Cancer multidrug resistance — targeted therapy in both cancer and cardiovascular system with cardiovascular drugs, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1306–1308. [63] S. Patanè, HERG-targeted therapy in both cancer and cardiovascular system with cardiovascular drugs, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1082–1085. [64] S. Patanè, Ebola: is there a hope from treatment with cardiovascular drugs? Int. J. Cardiol. 117 (2) (Dec 15 2014) 524–526. [65] S. Patanè, Cardiotoxicity: anthracyclines and long term cancer survivors, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1326–1328. [66] S. Patanè, Cardiotoxicity: trastuzumab and cancer survivors, Int. J. Cardiol. 77 (2) (Dec 15 2014) 554–556. [67] S. Patanè, The emerging scenario of the onco-cardiovascular patients, J. Cardiol. Ther. 1 (8) (2014) 141–149 (Available from: URL: http://www.ghrnet.org/index. php/jct/article/view/860/962). [68] S. Patanè, M3 muscarinic acetylcholine receptor in cardiology and oncology, Int. J. Cardiol. 177 (2) (Dec 15 2014) 646–649. [69] P. Pugliatti, A. Recupero, C. Zito, S. Patanè, The chance finding of an atrial septal defect in a cancer patient, Int. J. Cardiol. 177 (2) (Dec 15 2014) e68–69. [70] R. La Rocca, G. Ferrari-Toninelli, S. Patanè, Widened QRS interval and left ventricular systolic depression after propafenone and promazine exposure, Int. J. Cardiol. 177 (1) (Nov 15 2014) 57–60. [71] G.M. Calvagna, F. Ceresa, S. Patanè, Pocket infection as a complication of a subcutaneous implantable cardioverter-defibrillator, Int. J. Cardiol. 177 (2) (Dec 15 2014) 616–618. [72] F. Ceresa, G.M. Calvagna, S. Patanè, E.M. Di Maggio, P. Romeo, F. Patanè, Cardiac perforation of the right ventricle: a rare complication of pacemaker implantation. The importance of a collaborative vision of a multi-disciplinary treatment team, Int. J. Cardiol. 177 (2) (Dec 15 2014) 621–624. [73] G.M. Calvagna, S. Patanè, Intravascular recovery of electrode fragments as a possible complication of transvenous removal intervention, Int. J. Cardiol. 177 (2) (Dec 15 2014). [74] S. Patanè, Is there a role for quinazoline-based α(1)-adrenoceptor antagonists in cardio-oncology? Card. Drugs Ther. 28 (6) (Dec 2014) 587–588. [75] G.M. Calvagna, L. Costanzo, A. Di Pino, S. Patanè, Leads extraction in a young girl with dehiscence of a pacemaker implanted in the subpectoral region, Int. J. Cardiol. 176 (3) (Oct 20 2014) e135–e136. [76] P. Romeo, G.M. Calvagna, M. Giunta, F.V. Vitale, S. Patanè, Removal of an intracardiac lost port—a catheter utilizing a simple low-cost method, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1309–1311. [77] S. Patanè, Regulator of G-protein signaling 2 (RGS2) in cardiology and oncology, Int. J. Cardiol. 179 (Jan 20 2015) 63–65. [78] S. Patanè, Insights into cardio-oncology: the patient's heavy cancer journey among doubts, controversies and pitfalls. The role of the cardiologist, Int. J. Cardiol. 178C (Oct 28 2014) 175–177. [79] G.M. Calvagna, S. Patanè, Venous occlusion after transvenous pacemaker implantation — is there a role for new oral anticoagulants? Card. Drugs Ther. 29 (1) (Feb 2015) 99–100. [80] P. Pugliatti, R. Donato, C. De Gregorio, S. Patanè, A massive pericardial effusion in a cancer patient, Int. J. Cardiol. 181C (Nov 26 2014) 138–140. [81] G.M. Calvagna, S. Patanè, A subcutaneous finger cardioverter-defibrillator system removal under local anesthesia, Int. J. Cardiol. 179 (Jan 20 2015). [82] A. Schuchert, C. Muto, T. Maounis, R. Frank, E. Boulogne, A. Polauck, L. Padeletti, MASCOT study group, Lead complications, device infections, and clinical outcomes in the first year after implantation of cardiac resynchronization therapy-defibrillator and cardiac resynchronization therapy-pacemaker, Europace 15 (1) (Jan 2013) 71–76. [83] B.L. Wilkoff, et al., Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications and patient management, Heart Rhythm. 6 (2009) 1085. [84] G.M. Calvagna, S. Patanè, Cardiac rehabilitation in pacing patient complications: an increasing scenario requiring a collaborative vision of a multi-disciplinary treatment team, Int. J. Cardiol. 178C (Oct 24 2014) 168–170. [85] G.M. Calvagna, S. Patanè, Cardiac rehabilitation in pacing venous occlusions, Int. J. Cardiol. 179 (Jan 20 2015) 248–251.
G.M. Calvagna et al. / International Journal of Cardiology 185 (2015) 214–217 [86] G.M. Calvagna, S. Patanè, Pacing venous occlusion, Int. J. Cardiol. 181C (Nov 26 2014) 42–45. [87] G.M. Calvagna, S. Patanè, Transvenous pacemaker lead extraction by femoral approach, Int. J. Cardiol. 180C (Nov 25 2014) 145–148. [88] G.M. Calvagna, S. Patanè, A complete bicameral pacemaker pocket decubitus, Int. J. Cardiol. 181C (Dec 24 2014) 340–343.
217
[89] G.M. Calvagna, F. Ceresa, A. Morgante, S. Patanè, Transvenous extraction of a left subclavian dialysis catheter: a new challenge in cardiology, Int. J. Cardiol. 185 (Mar 10 2015) 144–147.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Letter to the Editor
Transvenous recovery of an intracardiac fractured port-A catheter fragment Giuseppe Mario Calvagna a,⁎, Salvatore Patanè a, Placido Romeo b, Sonja Condorelli c, Ludovico Vasquez a,d a
Cardiologia Ospedale San Vincenzo — Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy Radiologia Ospedale San Vincenzo — Taormina (Me), Azienda Sanitaria Provinciale di Messina, 98039 Taormina, Messina, Italy UOC Oncologia Presidio di Caltagirone, Azienda Sanitaria Provinciale di Catania, Italy d Cardiologia Presidio Ospedaliero “G. Fogliani” — Milazzo (ME), Azienda Sanitaria Provinciale di Messina, Italy b c
a r t i c l e
i n f o
Article history: Received 3 February 2015 Accepted 7 March 2015 Available online 10 March 2015 Keywords: Cardiac devices Chemotherapy Endocarditis Infections Port-A catheter Transvenous lead extraction
The optimal management of implanted devices has become a serious worldwide challenge and many techniques for addressing device complications have been developed including endovascular retrieval of lost or misplaced fractured foreign objects [1]. The use of implantable cardiac devices has increased in the last 30 years [1–46]. Infectious complications leading to endocarditis [2,6,8,28–36] and noninfectious complications [9,21,23,37–40] often necessitating removal [1,2,8,40–46] have affected patients' wellbeing and have also led to an increase in psychological difficulties [47–53]. This emerging scenario of concomitant problems and diseases [54–81] also includes patients needing device revision and upgrade. In addition, improved patients' survival, a progressively younger implanted population and the increase in device and procedure complexity have raised the risk of system component structural failures [82–87]. For these reasons, the necessity of extraction has become increasingly higher and the development of specific techniques and tools to reduce morbidity and mortality associated with the removal of pacing devices has played an important role representing the cornerstone of modern clinical cardiac electrophysiology as well as efficacious implantation and management of cardiac devices. A mechanical technique (transvenous lead extraction) is an effective ⁎ Corresponding author at: Cardiologia Ospedale San Vincenzo — Taormina (Me), Azienda Sanitaria Provinciale di Messina, Contrada Sirina, 98039 Taormina, Messina, Italy. E-mail address: [email protected] (G.M. Calvagna).
http://dx.doi.org/10.1016/j.ijcard.2015.03.087 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
technique with few complications, but the collaborative vision of a multi-disciplinary treatment team [53,72] is required for the patient's safety and complete rehabilitation [82–88]. The safety and effectiveness of transvenous lead extraction has also been demonstrated for difficult dialysis catheter [89] and port catheter removal [76]. The difficult extraction of dialysis catheters due to a hard fibrin sheath along their course and spontaneous fracture and migration of implanted port catheters are emerging common drawbacks [76,89] as well as the retrieval and removal of foreign intravascular bodies to prevent cardiovascular complications. We present the case of a 40-year-old Italian woman with a history of an implanted right subclavian port-A catheter in 2012 for colorectal adenocarcinoma chemotherapy. Chest X-ray examination revealed the presence of a spontaneous fracture and embolization and migration of a fixed fragment with a size of about 10 cm placed between the right atrium and right ventricle across the tricuspid valve (Fig. 1 panels A and B). We successfully performed the recovery of the fragment from the right femoral venous access through Seldinger's technique with a TIP Deflecting Wire Guide (Cook Vascolar) used for moving it and a recovery loop AndraSnare AS-25 (125 cm; 5 Fr; Andramed model) used for its capture (Fig. 2). Also this case focuses on the safety and effectiveness of transvenous lead extraction and it is illustrative of its use as a new challenge in cardiology. Author contributions Salvatore Patanè wrote the work. Giuseppe Mario Calvagna prepared the references and performed the fragment recovery. Sonja Condorelli prepared Fig. 1. Placido Romeo prepared Fig. 2. Ludovico Vasquez prepared the legends for Figs. 1 and 2. Conflict of interest The authors report no relationships that could be construed as a conflict of interest. Acknowledgments The authors of this manuscript have certified that they adhere to the statement of ethical publishing as appears in the International Journal of Cardiology.
G.M. Calvagna et al. / International Journal of Cardiology 185 (2015) 214–217
215
Fig. 1. (Panels A and B). Chest X-ray examination revealed the presence of a spontaneous fracture and embolization and migration of a fixed fragment with a size of about 10 cm placed between the right atrium and right ventricle across the tricuspid valve.
[8]
[9]
[10]
[11]
[12]
[13] Fig. 2. The fragment recovery performed successfully from the right femoral venous access through Seldinger's technique with a TIP Deflecting Wire Guide (Cook Vascolar) used for moving it and a recovery loop AndraSnare AS-25 (125 cm; 5 Fr; Andramed model) used for its capture.
[14]
[15]
[16]
References [1] G.M. Calvagna, P. Romeo, F. Ceresa, S. Valsecchi, Transvenous retrieval of foreign objects lost during cardiac device implantation or revision: a 10-year experience, Pacing Clin. Electrophysiol. 36 (7) (Jul 2013) 892–897. [2] G.M. Calvagna, S. Patanè, Severe staphylococcal sepsis in patient with permanent pacemaker, Int. J. Cardiol. 172 (3) (Apr 1 2014) e498–e501. [3] C. Ward, S. Henderson, N.H. Metcalfe, A short history on pacemakers, Int. J. Cardiol. 169 (4) (Nov 15 2013) 244–248. [4] K. Toutouzas, A. Synetos, D. Tousoulis, G. Latsios, S. Brili, A. Mastrokostopoulos, A. Karanasos, S. Sideris, P. Dilaveris, A. Cheong, C.M. Yu, C. Stefanadis, Predictors for permanent pacemaker implantation after core valve implantation in patients without preexisting ECG conduction disturbances: the role of a new echocardiographic index, Int. J. Cardiol. 172 (3) (Apr 1 2014) 601–603. [5] V. Giugno, F. Messina, S. Crosca, Treatment failure of low molecular weight heparin bridging therapy after implantation of a permanent pacemaker, Int. J. Cardiol. 173 (3) (May 15 2014) e23–e24. [6] J.A. Sandoe, G. Barlow, J.B. Chambers, M. Gammage, A. Guleri, P. Howard, E. Olson, J.D. Perry, B.D. Prendergast, M.J. Spry, R.P. Steeds, M.H. Tayebjee, R. Watkin, Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE), J. Antimicrob. Chemother. 70 (2) (Feb 2015) 325–359. [7] Y. Aizawa, S. Takatsuki, M. Negishi, S. Kashimura, Y. Katsumata, T. Nishiyama, T. Kimura, N. Nishiyama, Y. Tanimoto, K. Tanimoto, S. Kohsaka, M. Sano, K. Fukuda,
[17]
[18]
[19] [20]
[21]
[22]
[23] [24]
Clinical characteristics of atrial fibrillation detected by implanted devices and its association with ICD therapy, Int. J. Cardiol. 172 (3) (Apr 1 2014) e529–e530. M. Scarano, F. Pezzuoli, G. Torrisi, G.M. Calvagna, S. Patanè, Cardiovascular implantable electronic devices infective endocarditis, Int. J. Cardiol. 173 (3) (May 15 2014) e38–e39. S. Ahmed, P. Ungprasert, N. Srivali, S. Ratanapo, W. Cheungpasitporn, D. Chongnarungsin, Lead perforation: an uncommon cause of chest pain in a patient with pacemaker, Int. J. Cardiol. 167 (5) (Sep 1 2013) e113–e114. K.P. Van Galen, J. van Dijk, J.C. Regelink, P.C. Huijgens, M.C. Minnema, S. Zweegman, Implantable defibrillators in cardiac amyloidosis, Int. J. Cardiol. 165 (2) (May 10 2013) 371–373. F. Fang, Q. Zhang, J.Y. Chan, O. Razali, H. Azlan, H.C. Chan, J.E. Sanderson, J.M. Xie, C.M. Yu, Early pacing-induced systolic dyssynchrony is a strong predictor of left ventricular adverse remodeling: analysis from the Pacing to Avoid Cardiac Enlargement (PACE) trial, Int. J. Cardiol. 168 (2) (Sep 30 2013) 723–728. A. Sairaku, Y. Yoshida, Y. Nakano, Y. Kihara, Ablation of atrial fibrillation in Brugada syndrome patients with an implantable cardioverter defibrillator to prevent inappropriate shocks resulting from rapid atrial fibrillation, Int. J. Cardiol. 168 (6) (Oct 15 2013) 5273–5276. F. Fang, J.Y. Chan, A.P. Lee, S.H. Sung, X.X. Luo, X. Jiang, J.S. Kwong, J.E. Sanderson, C.M. Yu, Improved coronary artery blood flow following the correction of systolic dyssynchrony with cardiac resynchronization therapy, Int. J. Cardiol. 167 (5) (Sep 1 2013) 2167–2171. Z. Cheng, H. Deng, K. Cheng, T. Chen, P. Gao, Q. Fang, Implantation of a pacemaker in a patient with persistent left superior vena cava and absence of right superior vena cava, Int. J. Cardiol. 168 (2) (Sep 30 2013) e53–e54. C. Schukro, L. Leitner, J. Siebermair, T. Pezawas, G. Stix, J. Kastner, H. Schmidinger, Impact of accelerated ventricular tachyarrhythmias on mortality in patients with implantable cardioverter-defibrillator therapy, Int. J. Cardiol. 167 (6) (Sep 10 2013) 3006–3010. K.A. Gatzoulis, D. Tsiachris, P. Dilaveris, S. Archontakis, P. Arsenos, A. Vouliotis, S. Sideris, G. Trantalis, E. Kartsagoulis, I. Kallikazaros, C. Stefanadis, Implantable cardioverter defibrillator therapy activation for high risk patients with relatively well preserved left ventricular ejection fraction. Does it really work? Int. J. Cardiol. 167 (4) (Aug 20 2013) 1360–1365. M. Peyrol, P. Sbragia, B. Obadia, M. Laine, C. Villacampa, S. Armero, L. Bonello, J. Pinto, F. Thuny, F. Paganelli, The safety of cardiac resynchronization therapy pacemaker implantation in octogenarians: a monocentric experience, Int. J. Cardiol. 168 (3) (Oct 3 2013) 2969–2970. R. Sankaranarayanan, R. Visweswariah, D.J. Fox, New developments in cardiac resynchronization therapy, Br. J. Hosp. Med. (Lond.) 74 (9) (Sep 2013) 503–509. S. Patanè, Paced patient and acute myocardial infarction, Int. J. Cardiol. 161 (1) (Nov 1 2012) e16–e17. J. Veselka, J. Krejčí, P. Tomašov, V. Durdil, L. Riedlbauchová, J. Honěk, T. Honěk, D. Zemánek, Outcome of patients after alcohol septal ablation with permanent pacemaker implanted for periprocedural complete heart block, J. Cardiol. Int. 171 (2) (Feb 1 2014) e37–e38. R. La Rocca, V. Materia, M.F. Falliano, N. Sciacca, F. Marte, S. Patanè, Hyperkalaemic cardiac arrhythmia with pacemaker/implantable cardioverter-defibrillator action disturbance, Int. J. Cardiol. 156 (3) (May 3 2012) e49–e50. E.O. Udo, N.M. van Hemel, N.P. Zuithoff, H. Nijboer, W. Taks, P.A. Doevendans, K.G. Moons, Long term quality-of-life in patients with bradycardia pacemaker implantation, Int. J. Cardiol. 168 (3) (Oct 3 2013) 2159–2163. G.M. Calvagna, F. Ceresa, S. Patanè, Subcutaneous implantable cardioverterdefibrillator in a young woman, Int. J. Cardiol. 175 (2) (Aug 1 2014) e30–e32. F. Reinke, A. Löher, J. Köbe, L. Eckardt, Current status and problems of the entirely subcutaneous ICD (S-ICD®), Herzschrittmacherther. Elektrophysiol. 24 (3) (Sep 2013) 165–170 (German).
216
G.M. Calvagna et al. / International Journal of Cardiology 185 (2015) 214–217
[25] S. Aziz, A.R. Leon, M.F. El-Chami, The subcutaneous defibrillator—a review of the literature, J. Am. Coll. Cardiol. 63 (15) (Apr 22 2014) 1473–1479. [26] P.D. Lambiase, C. Barr, D.A. Theuns, R. Knops, P. Neuzil, J.B. Johansen, M. Hood, S. Pedersen, S. Kääb, F. Murgatroyd, H.L. Reeve, N. Carter, L. Boersma, on behalf of the EFFORTLESS Investigators, Worldwide experience with a totally subcutaneous implantable defibrillator: early results from the EFFORTLESS S-ICD Registry, Eur. Heart J. 35 (25) (Jul 1 2014) 1657–1665. [27] F. Akerström, M.A. Arias, M. Pachón, A. Puchol, J. Jiménez-López, Subcutaneous implantable defibrillator: state-of-the art 2013, World J. Cardiol. 5 (9) (Sep 26 2013) 347–354. [28] G.M. Calvagna, Recall, malfunzionamenti e infezioni in portatori di PM/ICD. Possono condizionare le scelte clinico-interventistiche e la qualità della vita? GIAC 13 (3–4) (2010) 217–222. [29] M. Scarano, F. Pezzuoli, S. Patanè, Brucella infective endocarditis, Int. J. Cardiol. 172 (3) (Apr 1 2014) e509–e510. [30] S. Patanè, Is there a need for bacterial endocarditis prophylaxis in patients undergoing urological procedures? J. Cardiovasc. Transl. Res. 7 (3) (Apr 2014) 369–371. [31] S. Patanè, Is there a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy? J. Cardiovasc. Transl. Res. 7 (3) (Apr 2014) 372–374. [32] G.M. Calvagna, Progressivo malfunzionamento di elettrocatetere da stimolazione cardiaca permanente secondario a processo infettivo asintomatico, GIAC 15 (1) (2012) 51–54. [33] G.M. Calvagna, S. Curatolo, S. La Greca, R. Evola, Sepsi Stafilococciche in pazienti portatori di PM e\o ICD: Dal trattamento antibiotico all'intervento di Rimozione Transvenosa Manuale, G. It. Aritmol. Cardiostim 13 (1) (Marzo 2010). [34] S. Patanè, A dark side of the cardio-oncology: the bacterial endocarditis prophylaxis, Int. J. Cardiol. 157 (3) (Jun 14 2012) 448–449. [35] G.M. Calvagna, A. Mangano, R. Evola, Infezioni su estremita' distali degli elettrocateteri da stimolazione cardiaca permanente rimossi mediante tecnica transvenosa manuale: casistica dal 2002 al 2007 presso centro unico dedicato, G. Ital. Aritmol. Cardiostim 4 (2008) 65–68. [36] G.M. Calvagna, S. Patanè, Transvenous pacemaker lead extraction in infective endocarditis, Int. J. Cardiol. 176 (2) (Sep 20 2014) 511–513. [37] M. Imazio, B.D. Hoit, Post-cardiac injury syndromes. An emerging cause of pericardial diseases, Int. J. Cardiol. 168 (2) (Sep 30 2013) 648–652. [38] A. Chikata, W. Omi, T. Saeki, H. Nagai, S. Sakagami, Repeated pacemaker dysfunction in a patient with recurrent takotsubo cardiomyopathy precipitated by hyponatremia, Int. J. Cardiol. 170 (3) (Jan 1 2014) 443–444. [39] H. Kawata, J. Patel, T. McGarry, R. Joshi, D. Krummen, G. Feld, U. Birgersdotter-Green, Obese female patients have higher rates of lead dislodgement after ICD or CRT-D implantation, Int. J. Cardiol. 172 (3) (Apr 1 2014) e522–e524. [40] G.M. Calvagna, R. Evola, Complicanze non infettive o malfunzionamenti in pazienti portatori di PM e/o ICD: importanza della rimozione transvenosa, G. Ital. Aritmol. Cardiostim 12 (2) (2009) 69–78. [41] G.M. Calvagna, S. Patanè, P. Romeo, F. Ceresa, F. Sansone, F. Patanè, Embolization and retrieval of an anchoring sleeve during transvenous lead extraction, Int. J. Cardiol. 173 (3) (May 15 2014) e42–e44. [42] G.M. Calvagna, R. Foti, M. Lisi, R. Evola, Rimozione transvenosa manuale di elettrocateteri da Pacemaker e\o ICD malfunzionanti o infetti mediante tecnica transvenosa manuale: Esperienza di unico centro regionale dedicato (anni 2002– 2007), G. It. Aritmol. Cadiostim 4 (2007) 30–35. [43] G.M. Calvagna, R. Evola, G. Scardace, S. Valsecchi, Single-operator experience with a mechanical approach for removal of pacing and implantable defibrillator leads, Europace 11 (11) (Nov 2009) 1505–1509. [44] G.M. Calvagna, R. Evola, G. Scardace, S. Valsecchi, Successful removal of a jugular implantable defibrillator lead with mechanical single-sheath technique, Pacing Clin. Electrophysiol. 35 (9) (Sep 2012) e258–e260. [45] G.M. Calvagna, R. Evola, S. Valsecchi, A complication of pacemaker lead extraction: pulmonary embolization of an electrode fragment, Europace 12 (2010) 613. [46] P. Kumar, J.D. Schwartz, Device therapies: new indications and future directions, Curr. Cardiol. Rev. 11 (1) (2015) 33–41. [47] S.S. Pedersen, M.T. Hoogwegt, L. Jordaens, D.A. Theuns, Procedure- and devicerelated complications and psychological morbidity in implantable cardioverter defibrillator patients, Int. J. Cardiol. 168 (1) (Sep 20 2013) 606–607. [48] M. Feola, P. Vallauri, L. Salvatico, A. Vado, M. Testa, Neuropsychological impact of implantable cardioverter defibrillator in congestive heart failure patients, Int. J. Cardiol. 166 (1) (Jun 5 2013) 275–276. [49] J. Denollet, F.B. Tekle, S.S. Pedersen, P.H. van der Voort, M. Alings, K.C. van den Broek, Prognostic importance of distressed (Type D) personality and shocks in patients with an implantable cardioverter defibrillator, Int. J. Cardiol. 167 (6) (Sep 10 2013) 2705–2709. [50] S.S. Pedersen, M.T. Hoogwegt, L. Jordaens, D.A. Theuns, Pre implantation psychological functioning preserved in majority of implantable cardioverter defibrillator patients 12 months post implantation, Int. J. Cardiol. 166 (1) (Jun 5 2013) 215–220. [51] J. Ingles, T. Sarina, N. Kasparian, C. Semsarian, Psychological wellbeing and posttraumatic stress associated with implantable cardioverter defibrillator therapy in young adults with genetic heart disease, Int. J. Cardiol. 168 (4) (Oct 9 2013) 3779–3784. [52] K.C. van den Broek, F.B. Tekle, M. Habibović, M. Alings, P.H. van der Voort, J. Denollet, Emotional distress, positive affect, and mortality in patients with an implantable cardioverter defibrillator, Int. J. Cardiol. 165 (2) (May 10 2013) 327–332.
[53] G.M. Calvagna, G. Torrisi, C. Giuffrida, S. Patanè, Pacemaker, implantable cardioverter defibrillator, CRT, CRT-D, psychological difficulties and quality of life, Int. J. Cardiol. 174 (2) (Jun 15 2014) 378–380. [54] P. Pugliatti, R. Donato, G. Di Bella, S. Carerj, S. Patanè, Contrast-enhancing right atrial thrombus in cancer patient, Int. J. Cardiol. 173 (3) (May 15 2014) e35–e37. [55] P. Pugliatti, R. Donato, C. Zito, S. Carerj, S. Patanè, Cardioinhibitory vasovagal syncope in a cancer patient, Int. J. Cardiol. 174 (2) (Jun 15 2014) e64–e65. [56] S. Patanè, Cardiotoxicity: cisplatin and long term cancer survivors, Int. J. Cardiol. 175 (1) (Jul 15 2014) 201–202. [57] S. Patanè, A challenge in cardiology: the oncosurgery, Int. J. Cardiol. 174 (2) (Jun 15 2014) 411–412. http://dx.doi.org/10.1016/j.ijcard.2014.04.046 (Epub 2014 Apr 13). [58] S. Patanè, Heart failure and breast cancer: emerging controversies regarding some cardioprotective strategies, J. Card. Fail. 20 (6) (Jun 2014) 456–457. [59] S. Patanè, Insights into cardio-oncology: adrenergic receptor signaling and pathways in breast cancer, Curr. Med. Res. Opin. (Jun 26 2014) 1–2. [60] S. Patanè, Breast cancer treatment cardioprotective strategies: the King is naked, J. Am. Heart Assoc. (2014) (Published July 22,2014 http://www.jaha.ahajournals.org/content/ 3/2/e000665/reply). [61] S. Patanè, ERBB1/EGFR and ERBB2 (HER2/neu) — targeted therapies in cancer and cardiovascular system with cardiovascular drugs, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1301–1303. [62] S. Patanè, Cancer multidrug resistance — targeted therapy in both cancer and cardiovascular system with cardiovascular drugs, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1306–1308. [63] S. Patanè, HERG-targeted therapy in both cancer and cardiovascular system with cardiovascular drugs, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1082–1085. [64] S. Patanè, Ebola: is there a hope from treatment with cardiovascular drugs? Int. J. Cardiol. 117 (2) (Dec 15 2014) 524–526. [65] S. Patanè, Cardiotoxicity: anthracyclines and long term cancer survivors, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1326–1328. [66] S. Patanè, Cardiotoxicity: trastuzumab and cancer survivors, Int. J. Cardiol. 77 (2) (Dec 15 2014) 554–556. [67] S. Patanè, The emerging scenario of the onco-cardiovascular patients, J. Cardiol. Ther. 1 (8) (2014) 141–149 (Available from: URL: http://www.ghrnet.org/index. php/jct/article/view/860/962). [68] S. Patanè, M3 muscarinic acetylcholine receptor in cardiology and oncology, Int. J. Cardiol. 177 (2) (Dec 15 2014) 646–649. [69] P. Pugliatti, A. Recupero, C. Zito, S. Patanè, The chance finding of an atrial septal defect in a cancer patient, Int. J. Cardiol. 177 (2) (Dec 15 2014) e68–69. [70] R. La Rocca, G. Ferrari-Toninelli, S. Patanè, Widened QRS interval and left ventricular systolic depression after propafenone and promazine exposure, Int. J. Cardiol. 177 (1) (Nov 15 2014) 57–60. [71] G.M. Calvagna, F. Ceresa, S. Patanè, Pocket infection as a complication of a subcutaneous implantable cardioverter-defibrillator, Int. J. Cardiol. 177 (2) (Dec 15 2014) 616–618. [72] F. Ceresa, G.M. Calvagna, S. Patanè, E.M. Di Maggio, P. Romeo, F. Patanè, Cardiac perforation of the right ventricle: a rare complication of pacemaker implantation. The importance of a collaborative vision of a multi-disciplinary treatment team, Int. J. Cardiol. 177 (2) (Dec 15 2014) 621–624. [73] G.M. Calvagna, S. Patanè, Intravascular recovery of electrode fragments as a possible complication of transvenous removal intervention, Int. J. Cardiol. 177 (2) (Dec 15 2014). [74] S. Patanè, Is there a role for quinazoline-based α(1)-adrenoceptor antagonists in cardio-oncology? Card. Drugs Ther. 28 (6) (Dec 2014) 587–588. [75] G.M. Calvagna, L. Costanzo, A. Di Pino, S. Patanè, Leads extraction in a young girl with dehiscence of a pacemaker implanted in the subpectoral region, Int. J. Cardiol. 176 (3) (Oct 20 2014) e135–e136. [76] P. Romeo, G.M. Calvagna, M. Giunta, F.V. Vitale, S. Patanè, Removal of an intracardiac lost port—a catheter utilizing a simple low-cost method, Int. J. Cardiol. 176 (3) (Oct 20 2014) 1309–1311. [77] S. Patanè, Regulator of G-protein signaling 2 (RGS2) in cardiology and oncology, Int. J. Cardiol. 179 (Jan 20 2015) 63–65. [78] S. Patanè, Insights into cardio-oncology: the patient's heavy cancer journey among doubts, controversies and pitfalls. The role of the cardiologist, Int. J. Cardiol. 178C (Oct 28 2014) 175–177. [79] G.M. Calvagna, S. Patanè, Venous occlusion after transvenous pacemaker implantation — is there a role for new oral anticoagulants? Card. Drugs Ther. 29 (1) (Feb 2015) 99–100. [80] P. Pugliatti, R. Donato, C. De Gregorio, S. Patanè, A massive pericardial effusion in a cancer patient, Int. J. Cardiol. 181C (Nov 26 2014) 138–140. [81] G.M. Calvagna, S. Patanè, A subcutaneous finger cardioverter-defibrillator system removal under local anesthesia, Int. J. Cardiol. 179 (Jan 20 2015). [82] A. Schuchert, C. Muto, T. Maounis, R. Frank, E. Boulogne, A. Polauck, L. Padeletti, MASCOT study group, Lead complications, device infections, and clinical outcomes in the first year after implantation of cardiac resynchronization therapy-defibrillator and cardiac resynchronization therapy-pacemaker, Europace 15 (1) (Jan 2013) 71–76. [83] B.L. Wilkoff, et al., Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications and patient management, Heart Rhythm. 6 (2009) 1085. [84] G.M. Calvagna, S. Patanè, Cardiac rehabilitation in pacing patient complications: an increasing scenario requiring a collaborative vision of a multi-disciplinary treatment team, Int. J. Cardiol. 178C (Oct 24 2014) 168–170. [85] G.M. Calvagna, S. Patanè, Cardiac rehabilitation in pacing venous occlusions, Int. J. Cardiol. 179 (Jan 20 2015) 248–251.
G.M. Calvagna et al. / International Journal of Cardiology 185 (2015) 214–217 [86] G.M. Calvagna, S. Patanè, Pacing venous occlusion, Int. J. Cardiol. 181C (Nov 26 2014) 42–45. [87] G.M. Calvagna, S. Patanè, Transvenous pacemaker lead extraction by femoral approach, Int. J. Cardiol. 180C (Nov 25 2014) 145–148. [88] G.M. Calvagna, S. Patanè, A complete bicameral pacemaker pocket decubitus, Int. J. Cardiol. 181C (Dec 24 2014) 340–343.
217
[89] G.M. Calvagna, F. Ceresa, A. Morgante, S. Patanè, Transvenous extraction of a left subclavian dialysis catheter: a new challenge in cardiology, Int. J. Cardiol. 185 (Mar 10 2015) 144–147.
