Severe lead induced tricuspid regurgitation - clinical impact of repair or replacement of tricuspid valve

• DOI: 10.1093/europace/euae102.522
• Publication Date: 2024-05-24T12:28:59Z
• Authors: A R Santos; F Albuquerque; A Castelo; V Ferreira; P Rio; A T Timoteo; A Galrinho; L Branco; F Varela; A Leal; H Santos; B Valente; P Osorio; M Oliveira; R Ferreira
• Keywords: Tricuspid Valve Insufficiency; Lead (geology)

Abstract The prevalence of lead-induced tricuspid regurgitation (LITR) ranges between 7 to 45%. most frequent mechanism LITR is the impingement leaflets, but right ventricle remodelling, pacing-induced cardiomyopathy and annular dilatation also can contribute severity (TR). Different studies concluded that was associated with an increased risk all-cause mortality heart failure hospitalizations. Beyond diuretics, patients (P) may be candidates for interventional treatment, including lead extraction, surgery, or percutaneous trans-catheter ‘edge-to-edge’ repair (TEER) heterotopic bicaval devices (HBD). Despite its importance, there a scarcity data concerning management clinical impact severe LITR. purpose current analysis improve knowledge regarding treatment on outcomes in this population. Methods A retrospective, single-centre made P referred evaluation eligibility intervention tertiary hospital. All were evaluated using both transthoracic echocardiography (TTE) transoesophageal (TEE). Data collected characterization, management, follow-up. Results From January 2020 September 2023, 97 eligibility, 36 (37%) had LITR, 14 cases (39%) presenting as TR mechanism. majority female (58%), median age 78 [IQR 72-83] years. Median Euroscore II 6 % 3-9]), 51% having previous 97% atrial fibrillation. Prior cardiac electronic device (CIED) implantation, 14% already presented TR. When analysing post-CIED TR, 30% 1 grade at 1-year follow-up, 68% 2 grades 5 According TTE, ventricular desynchrony present P. After underwent (22% - TEER HBD 8% surgical). remained electrodes. Mortality 21.1% population 78.9% remaining pts (p=0.027). type no statistically significant differences outcome. Conclusions In our study, more than 1/3 due underlying As previously reported, intervened better pts.