{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T03:59:36Z","timestamp":1780891176556,"version":"3.54.1"},"reference-count":12,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T00:00:00Z","timestamp":1780790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>The increasing use of cardiac implantable electronic devices (CIEDs) in pediatric and adolescent populations has led to a growing need for transvenous lead extraction (TLE). However, data on long-term outcomes remain limited. This study aimed to evaluate the efficacy and safety of TLE using mechanical rotational dilator sheaths in a pediatric cohort. This retrospective single-center study included 35 patients who underwent TLE between 2007 and 2025. Outcomes were compared between Evolution\u00ae (Cook Medical, Bloomington, IN, USA) and TightRail\u2122 (Spectranetics\/Philips, Colorado Springs, CO, USA) sheath systems. A total of 40 leads were extracted (mean age at extraction: 15.1 \u00b1 4.2 years; 57% male). The most common indication for extraction was lead fracture\/dysfunction (22\/35\u201363%). Complete success with the procedure was achieved in 23 (66%) patients, and clinical success in 30 (86%). Major complications requiring surgery occurred in 5 (14%) patients, and minor complications in 2 (6%). Notably, all major complications occurred in patients with implantable cardioverter-defibrillator (ICD) leads (p = 0.013), including innominate vein injury, pericardial effusion, tricuspid entrapment, and cardiac perforation. A comparison of the Evolution\u00ae (n:20) and TightRail\u2122 (n:15) sheath groups showed no statistically significant differences in complete procedural success (p = 0.603), clinical success (p = 0.604), or the incidence of major complications (p = 0.640). No procedure-related mortality was observed. TLE using mechanical rotational dilator sheaths in pediatric patients is feasible and provides acceptable clinical success rates. However, the risk of major complications remains considerable, particularly in patients with ICD leads. These findings highlight the importance of careful procedural planning and performing TLE in experienced centers with immediate surgical backup.<\/jats:p>","DOI":"10.3390\/jcdd13060253","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T02:32:46Z","timestamp":1780885966000},"page":"253","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transvenous Lead Extraction Using Mechanical Rotational Dilator Sheaths: A 19-Year Single-Center Experience from a Pediatric Cardiology Center"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5136-3977","authenticated-orcid":false,"given":"Hayrettin Hakan","family":"Aykan","sequence":"first","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara 06100, T\u00fcrkiye"},{"name":"Life Support Center, Hacettepe University, Ankara 06100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4316-2002","authenticated-orcid":false,"given":"Musa","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara 06100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4689-5888","authenticated-orcid":false,"given":"Yasemin Nuran","family":"D\u00f6nmez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Ankara Training and Research Hospital, Ankara 06100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130lker","family":"Ertu\u011frul","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara 06100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpay","family":"\u00c7eliker","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, VKV American Hospital, \u0130stanbul 34365, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tevfik","family":"Karag\u00f6z","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara 06100, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.ccep.2023.06.003","article-title":"Lead Management in Patients with Congenital Heart Disease","volume":"15","author":"Dasgupta","year":"2023","journal-title":"Card. Electrophysiol. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1161\/CIRCEP.110.957324","article-title":"Lead Extraction in Pediatric and Congenital Heart Disease Patients","volume":"3","author":"Cecchin","year":"2010","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.1111\/j.1540-8159.2008.00954.x","article-title":"Practical Aspects of Implantable Defibrillator Therapy in Patients with Congenital Heart Disease","volume":"31","author":"Walsh","year":"2008","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1253\/circj.CJ-22-0542","article-title":"Transvenous Lead Extraction in Pediatric Patients\u2014Is It the Same Procedure in Children as in Adults?","volume":"87","author":"Kutarski","year":"2023","journal-title":"Circ. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/jce.16147","article-title":"Safety and Feasibility of Same-day Discharge Following Uncomplicated Transvenous Lead Extraction","volume":"35","author":"Gianni","year":"2024","journal-title":"Cardiovasc. Electrophysiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.jacep.2021.11.008","article-title":"Lead Extraction at a Pediatric\/Congenital Heart Disease Center: The Importance of Patient Age at Implant","volume":"8","author":"Pham","year":"2022","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Heck, R., Peters, B., Lanm\u00fcller, P., Photiadis, J., Berger, F., Falk, V., Starck, C., and Kramer, P. (2023). Transvenous Lead Extraction in Children with Bidirectional Rotational Dissection Sheaths. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1256752"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Czajkowski, M., Jache\u0107, W., Polewczyk, A., Kosior, J., Nowosielecka, D., Tu\u0142ecki, \u0141., Stefa\u0144czyk, P., and Kutarski, A. (2021). Risk Factors for Lead-Related Venous Obstruction: A Study of 2909 Candidates for Lead Extraction. J. Clin. Med., 10.","DOI":"10.3390\/jcm10215158"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.15420\/aer.2024.09","article-title":"Conduction System Pacing in Children and Congenital Heart Disease","volume":"13","author":"Cano","year":"2024","journal-title":"Arrhythm. Electrophysiol. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1007\/s10840-023-01590-0","article-title":"Transvenous Lead Extraction of Lumenless 3830 Pacing Lead in Conduction System Pacing: A Single-Center Experience","volume":"67","author":"Migliore","year":"2023","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e014424","DOI":"10.1161\/CIRCEP.125.014424","article-title":"Safety and Efficacy of the Novel OmniaSecure Defibrillation Lead Through Long-Term Follow-Up: Final Results From the LEADR Trial","volume":"19","author":"Crossley","year":"2026","journal-title":"Circ. Arrhythm. Electrophysiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.1111\/jce.15006","article-title":"Comparison of Acute and Long-term Outcomes of Evolution\u00ae and TightRailTM Mechanical Dilator Sheaths during Transvenous Lead Extraction","volume":"32","author":"Canpolat","year":"2021","journal-title":"Cardiovasc. Electrophysiol."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/6\/253\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T03:40:42Z","timestamp":1780890042000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/6\/253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,7]]},"references-count":12,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcdd13060253"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13060253","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,7]]}}}