title: Entrapment of a Pacing Lead within a Chiari Network: Utility of Intracardiac Echo and a Laser Sheath.
abstract: Although rare, Chiari networks are elaborate embryological remnants that can pose distinct challenges for catheter and pacing lead manipulation within the right atrium. Device entrapment may require open thoracotomy for removal, with significant morbidity. We report an unusual case of pacing lead entanglement within this structure, followed by prompt intracardiac echocardiographic identification and laser sheath removal.
authors.affiliation: Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Htin
authors.initials: H
authors.lastname: Aung
authors.affiliation: Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Raul E
authors.initials: RE
authors.lastname: Espinosa
authors.affiliation: Sanger Heart & Vascular Institute, Charlotte, North Carolina.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Powell
authors.affiliation: Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McLeod
mesh_terms: D000328:Adult; D017147:Defibrillators, Implantable; D020878:Device Removal / Q000379:methods*; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D007834:Lasers
keywords: Chiari Network; defibrillator; laser extraction