Key result
Transvenous laser lead extraction followed by transcatheter tricuspid valve-in-valve replacement successfully resolved severe tricuspid regurgitation and heart failure symptoms in a high-risk patient.
Why the study?
Bioprosthetic tricuspid valves degenerate over time and patients often have pacemaker leads across the valve, presenting complex challenges for valve replacement in high-risk surgical candidates.
Case Report (n=1)
No
Transvenous lead extraction followed by transcatheter tricuspid valve-in-valve replacement is a feasible and effective approach for high-surgical-risk patients with degenerated bioprosthetic tricuspid valves and lead impingement.
Patients who undergo tricuspid valve replacement (TVR) are often complex and have multivalvular disease. These patients often require pacemaker placement owing to postoperative heart block. Over time, bioprosthetic valves degenerate, warranting replacement. Off-label use of a transcatheter valve to replace a degenerated bioprosthetic valve in the tricuspid position has been reported previously in patients who are at high risk for surgical reintervention. We report a complex case of a pacemaker-dependent patient with severe tricuspid regurgitation in a degenerated bovine TVR complicated by pacemaker lead impediment.
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Saleh et al. (2021) conducted a case report in Severe tricuspid regurgitation in a degenerated bioprosthetic valve with pacing lead impediment (n=1). Laser lead extraction and transcatheter tricuspid valve-in-valve replacement was evaluated on Procedural success and clinical improvement. Transvenous laser lead extraction followed by transcatheter tricuspid valve-in-valve replacement successfully resolved severe tricuspid regurgitation and heart failure symptoms in a high-risk patient.
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