Why the study?
Many patients referred for TTVI have a CIED, and surgical TR correction carries high morbidity and mortality while TLE carries risks and often fails to improve TR. As multiple TTVI devices are in trials, understanding appropriate therapies is essential.
This review summarizes nonsurgical treatment options, including transvenous lead extraction and transcatheter tricuspid valve interventions, for patients with tricuspid regurgitation and concurrent cardiac implantable electronic devices.
A large proportion of patients referred for transcatheter tricuspid valve intervention (TTVI) will have the presence of a cardiac implantable electronic device (CIED). In such patients, surgical correction of tricuspid regurgitation (TR) is associated with high rates of morbidity and mortality. Transvenous lead extraction (TLE) could potentially ameliorate CIED-induced TR; however, it carries inherent risks and frequently does not result in TR improvement. As multiple TTVI devices are in trial to gain regulatory approval, understanding which therapy is most appropriate among patients with a CIED is essential. This review centers on the nonsurgical treatment, including TLE and transcatheter tricuspid valve repair and replacement options, aimed at enhancing outcomes in patients with TR who also have concurrent CIEDs.
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Basman et al. (2024) studied this question.
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