Key result
T-TEER successfully treats severe TR post-lead extraction in 3 of 4 surgery-ineligible patients.
Why the study?
Severe tricuspid regurgitation induced by transvenous pacemaker lead extraction may require surgical correction, but affected patients are not always appropriate candidates for open-heart surgery.
Does transcatheter tricuspid edge-to-edge repair (T-TEER) successfully treat iatrogenic severe-torrential tricuspid regurgitation following transvenous pacemaker lead extraction in patients with prohibitive surgical risk?
Does transcatheter tricuspid edge-to-edge repair (T-TEER) successfully treat iatrogenic severe-torrential tricuspid regurgitation following transvenous pacemaker lead extraction in patients with prohibitive surgical risk?
Transcatheter tricuspid edge-to-edge repair is a feasible therapeutic option for patients with severe iatrogenic tricuspid regurgitation following pacemaker lead extraction who have prohibitive surgical risk.
T-TEER feasible for iatrogenic TR post-lead extraction in nonsurgical candidates; hypothesis-generating and requires larger prospective evaluation.
Background New tricuspid regurgitation (TR) or worsening of baseline pathology may appear after transvenous pacemaker lead extraction (TLE). In case of severe TR induced by TLE surgical correction might be required. However, the patients in whom TLE is performed are not always appropriate candidates for open heart intervention. Case Summary Herein we present four patients with iatrogenic TR significantly increased to severe-torrential grade after TLE who were disqualified from surgery. In three cases, the regurgitation was associated with an avulsion of the papillary muscles or chordae tendineae. In one case, it was likely due to the perforation of the tricuspid leaflet during TLE. Patients were treated with transcatheter tricuspid edge-to-edge repair (T-TEER), in three cases successfully. Discussion Percutaneous repair of TLE-related TR is feasible and may be a valuable therapeutic option in patients with prohibitive surgical risk. One of the most important factors leading to a T-TEER procedural success is the accurate assessment of the tricuspid regurgitation mechanism. In the fourth case, identification of the underlying regurgitation cause was limited by the image quality in transesophageal examination.
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Skowroński et al. (2026) studied this question. Transcatheter tricuspid edge-to-edge repair successfully treated severe tricuspid regurgitation post-lead extraction in 3 of 4 patients ineligible for surgery.
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