Author + information
- Received January 27, 2020
- Revision received April 21, 2020
- Accepted April 28, 2020
- Published online September 7, 2020.
- Jason H. Anderson, MDa,b,∗ (, )
- Doff B. McElhinney, MDc,d,
- Jamil Aboulhosn, MDe,
- Yulin Zhang, PhDc,
- Flavio Ribichini, MDf,
- Andreas Eicken, MDg,
- Brian Whisenant, MDh,
- Thomas Jones, MDi,
- Ran Kornowski, MDj,
- Danny Dvir, MDk,
- Allison K. Cabalka, MDa,b,
- for the VIVID Registry
- aDepartment of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota
- bDepartment of Cardiovascular Medicine, Division of Structural Heart Diseases, Mayo Clinic, Rochester, Minnesota
- cDivision of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
- dDivision of Pediatric Cardiac Surgery, Department of Cardiothoracic Surgery, Stanford University School of Medicine, Palo Alto, California
- eAhmanson/UCLA Adult Congenital Heart Disease Center, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
- fCardiovascular Division, Department of Medicine, University Hospital of Verona, Verona, Italy
- gDepartment of Congenital Heart Diseases and Pediatric Cardiology, German Heart Center Munich, Munich, Germany
- hIntermountain Heart Institute, Intermountain Medical Center, Salt Lake City, Utah
- iDivision of Pediatric Cardiology, Seattle Children’s Hospital and University of Washington School of Medicine, Seattle, Washington
- jDepartment of Cardiology, Rabin Medical Center, Petach Tikva, Israel
- kDivision of Cardiology, Department of Medicine, University of Washington, Seattle, Washington
- ↵∗Address for correspondence:
Dr. Jason H. Anderson, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.
Objectives The aim of this study was to determine the prevalence of pacemaker lead–related complications following transcatheter tricuspid valve replacement (TTVR).
Background The rate of permanent pacemaker implantation following tricuspid valve (TV) surgery is high, and many patients have transvenous leads. The feasibility, safety, and outcomes of subsequently performing TTVR in the setting of transvenous pacemaker leads have not been established.
Methods The VIVID (Valve-in-Valve International Database) registry was used to review 329 patients who underwent TTVR following TV repair or replacement. Patients were subdivided into 3 cohorts for intergroup comparisons: no lead, epicardial lead, and transvenous lead (entrapped or not entrapped during the TTVR procedure).
Results Of 329 patients who underwent TTVR, 128 (39%) had prior pacing systems in place, 70 with epicardial and 58 with transvenous leads. A total of 31 patients had leads passing through the TV. Three patients had the right ventricular (RV) lead extracted prior to TTVR. The remaining 28 patients had the RV lead entrapped between the transcatheter TV implant and the surgical valve (n = 22) or the repaired TV (n = 6). One patient had displacement of the RV lead during the procedure, and 2 experienced lead failure during follow-up. Overall, there was no significant difference in the cumulative incidences of competing outcomes (death, TV reintervention, TV dysfunction) between patients with and those without pacing leads or entrapped RV leads.
Conclusions TTVR in the setting of trans-TV pacemaker leads without lead extraction or re-replacement can be performed safely with a low risk for complications, offering an alternative to surgical TV replacement.
Dr. Jones serves as a consultant for Medtronic; and has received research grant support from Medtronic and Edwards Lifesciences. Dr. Eicken serves as a proctor for the Medtronic Melody valve. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Cardiovascular Interventions author instructions page.
- Received January 27, 2020.
- Revision received April 21, 2020.
- Accepted April 28, 2020.
- 2020 American College of Cardiology Foundation
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