Evaluation of tricuspid valve regurgitation following laser lead extraction†

TY - JOUR

T1 - Evaluation of tricuspid valve regurgitation following laser lead extraction†

AU - Pecha, Simon

AU - Castro, Liesa

AU - Gosau, Nils

AU - Linder, Matthias

AU - Vogler, Julia

AU - Willems, Stephan

AU - Reichenspurner, Hermann

AU - Hakmi, Samer

N1 - © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

PY - 2017/6/1

Y1 - 2017/6/1

N2 - OBJECTIVES: The objective of this study was to examine the effect of laser lead extraction (LLE) on the development of post-procedural tricuspid regurgitation (TR). Some reports have suggested an increase in TR associated with LLE. We present a series of patients who underwent both, LLE and complete echocardiographic evaluation for TR.METHODS: A single centre analysis of consecutive patients referred for LLE between January 2012 and August 2015. One hundred and three patients had tricuspid valve function evaluated before the procedure with a transthoracic echocardiography (TTE), during the procedure using transoesophageal echocardiography and postoperatively using a TTE. TR was graded from 0 (none) to 4 (severe).RESULTS: We treated 235 leads in 103 patients, including 118 ventricular leads. Seventy-seven were male (74.8%) and 26 female (25.2%), with a mean age of 65.6 ± 15.4 years. Mean time from initial lead implantation was 98.0 ± 67.3 months. Twenty-one patients (20.4%) had ejection fraction below 30%. No intra-procedural worsening of tricuspid valve function was seen with TEE in any of the patients. Ten patients (9.7%) were found to have TR before LLE that returned to normal valve function after the procedure. Two patients (1.9%) experienced mild TR after the procedure (both with tricuspid valve endocarditis). Ninety-one patients (88.3%) did not experience any significant change of the tricuspid valve function after LLE.CONCLUSION: Transthoracic and transoesophageal echocardiography findings showed that laser lead extraction was not associated with a significant increase in the incidence of tricuspid valve regurgitation.

AB - OBJECTIVES: The objective of this study was to examine the effect of laser lead extraction (LLE) on the development of post-procedural tricuspid regurgitation (TR). Some reports have suggested an increase in TR associated with LLE. We present a series of patients who underwent both, LLE and complete echocardiographic evaluation for TR.METHODS: A single centre analysis of consecutive patients referred for LLE between January 2012 and August 2015. One hundred and three patients had tricuspid valve function evaluated before the procedure with a transthoracic echocardiography (TTE), during the procedure using transoesophageal echocardiography and postoperatively using a TTE. TR was graded from 0 (none) to 4 (severe).RESULTS: We treated 235 leads in 103 patients, including 118 ventricular leads. Seventy-seven were male (74.8%) and 26 female (25.2%), with a mean age of 65.6 ± 15.4 years. Mean time from initial lead implantation was 98.0 ± 67.3 months. Twenty-one patients (20.4%) had ejection fraction below 30%. No intra-procedural worsening of tricuspid valve function was seen with TEE in any of the patients. Ten patients (9.7%) were found to have TR before LLE that returned to normal valve function after the procedure. Two patients (1.9%) experienced mild TR after the procedure (both with tricuspid valve endocarditis). Ninety-one patients (88.3%) did not experience any significant change of the tricuspid valve function after LLE.CONCLUSION: Transthoracic and transoesophageal echocardiography findings showed that laser lead extraction was not associated with a significant increase in the incidence of tricuspid valve regurgitation.

KW - Aged

KW - Aged, 80 and over

KW - Defibrillators, Implantable/adverse effects

KW - Device Removal/adverse effects

KW - Echocardiography, Transesophageal

KW - Female

KW - Humans

KW - Laser Therapy/adverse effects

KW - Male

KW - Middle Aged

KW - Pacemaker, Artificial/adverse effects

KW - Retrospective Studies

KW - Tricuspid Valve Insufficiency/diagnostic imaging

U2 - 10.1093/ejcts/ezx011

DO - 10.1093/ejcts/ezx011

M3 - SCORING: Journal article

C2 - 28204134

VL - 51

SP - 1108

EP - 1111

JO - EUR J CARDIO-THORAC

JF - EUR J CARDIO-THORAC

SN - 1010-7940

IS - 6

ER -