Snaring via a Femoral Approach to Facilitate Transvenous Lead Extraction of an Infected Right Ventricular Lead Jailed by a Bioprosthetic Tricuspid Valve

An 85-year-old woman presented with <i>Corynebacterium</i> bacteremia complicated by infective endocarditis with vegetations on the prosthetic mitral valve and right ventricular (RV) lead. The patient had a single-chamber permanent pacemaker with two RV leads, one of which was previously trapped or "jailed" after a bioprosthetic tricuspid valve replacement. Complete transvenous lead extraction including the chronically retained jailed RV lead was achieved via laser extraction assisted by concomitant traction from a superior left subclavian and inferior right femoral venous approach.