Transvenous valve-in-valve replacement preserving the function of a transvalvular defibrillator lead.

Abstract

Although feasibility and efficacy of percutaneous tricuspid valve-in-valve implantation have been established, a transtricuspid pacing or defibrillator lead might preclude this technique: lead damage can cause lead dysfunction resulting in inappropriate or inefficient pacing or shocks. In these cases, lead removal is thought to be the only option. We describe a patient who presented with rapid clinical deterioration due to tricuspid valve stenosis early after implantation of an internal defibrillator with a transvalvular shock-lead. A transvenous valve-in-valve implantation of the tricuspid valve was performed after protecting the defibrillator-lead with a custom-made covered stent. We describe the technical issues, the clinical outcome, and the evolution of lead function after implantation.

• Authors: Pieter De Meester, Werner Budts, Marc Gewillig
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 84 Issue 7 Pg. 1148-52 (Dec 01 2014) ISSN: 1522-726X [Electronic] United States
• PMID: 24677782 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2014 Wiley Periodicals, Inc.

Topics

• Adult
• Angiography
• Catheterization, Central Venous (methods)
• Defibrillators, Implantable (adverse effects)
• Echocardiography, Doppler
• Follow-Up Studies
• Heart Valve Prosthesis Implantation (methods)
• Humans
• Jugular Veins
• Male
• Tachycardia, Ventricular (therapy)
• Tricuspid Valve Stenosis (diagnosis, etiology, surgery)