Key result
TTVR with jailed CIED leads is safe but linked to increased paravalvular leak and TR.
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Why the study?
Is orthotopic transcatheter tricuspid valve replacement (TTVR) safe and effective in patients with transvalvular CIED leads?
Is orthotopic transcatheter tricuspid valve replacement (TTVR) safe and effective in patients with transvalvular CIED leads?
Orthotopic TTVR is safe and feasible in patients with transvalvular CIED leads, though jailed leads increase the risk of paravalvular leak and residual tricuspid regurgitation, necessitating close follow-up and alternative pacing strategies.
Jailed leads during TTVR were associated with more paravalvular leak; hypothesis-generating and leaves open optimal lead strategies.
Orthotopic TTVR in patients with transvalvular CIED leads can be safely and effectively performed with low rates of lead failure. Significant paravalvular leak and residual tricuspid regurgitation is more common with a jailed lead. These patients require close CIED follow-up with alternative pacing strategies in place, particularly when pacing dependent. (Global Multicenter Registry on Transcatheter TRIcuspid Valve RePLACEment [TRIPLACE]; NCT06033274).
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Traynor et al. (2026) studied this question. Transcatheter tricuspid valve replacement in patients with CIED leads was performed safely, but significantly increased paravalvular leak and tricuspid regurgitation occurred with jailed leads.
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