Biomedical Engineering Reference
In-Depth Information
of the device header to be cut off and to save the stuck
leads.
Protect the operated anatomy with a suitable cover so that
location of endocardial fixation. The intervention does not
describe the explantation procedure as the reverse order of
the implantation; instead it deals with a complex intervention
of the lead extraction with the appropriate risks.
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any chippings do not get into the patient's body.
Hold the device securely with flat-nosed pliers.
•
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Place the large cutting pliers with a joint on the back part
12.5.2 Explanting Devices
of the header a secure distance from the end of the lead
connector but still on the lead so the lead terminal connec-
tors are not damaged.
Press the handle of the pliers and cut through the lead case
The technique for device explantation is similar to that of their
replacement. Devices and leads explanted ahead of schedule
(source discharge, infection, technical problems, and patient
death) should be returned to the manufacturer because their
investigation might provide information for improvement of
the reliability of the device and provision of guarantees.
Explanted medical devices must not be implanted to another
patient because their sterility, functionality, and reliability
cannot be guaranteed. For ethical and technical reasons it is
recommended that devices be explanted postmortem.
Before explanting, cleaning, or sending a device, perform
the following steps:
Switch off the pacing and tachycardia mode of the
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in the back part of the header and uncover the connectors'
pins.
When the lead case is uncovered, push the connector pin
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from the header by means of a torque wrench or pliers and
at the same time gently pull the lead connector.
Because the electronic circuits are placed in the area of
the cut, cardiac pacing will be aborted by cutting off the
header. Therefore, temporary pacing must be ensured for
pacing-dependent patients.
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12.5
Explantation
device.
Switch off the function of magnet response.
•
12.5.1 Explanting Leads
•
Switch off acoustic end-of-life signalization.
•
Print a message about the final programmed mode and
Explanation or replacement of the endocardial leads are
interventions that carry huge risk. This risk increases with
the time that has passed after implantation. It is stated that
leads might be extracted easily in the first 3 months after
implantation [40]. One year or more after implantation, a lot
of fibrous tissue bridges along the whole length of the lead,
especially in the right ventricle and tricuspid valve and at the
states of counters and memory.
Clean and disinfect the device and leads with disinfectant
while complying with the techniques valid for biological risk
so that body fluids and tissue rests are removed. However,
never bathe the device or let fluid penetrate the lead ports.
Then, pack the device thoroughly in the return kit and send it
to the manufacturer.
