Tricuspid Valve Damage Related to Transvenous Lead Extraction

Anna Polewczyk (), Wojciech Jacheć, Dorota Nowosielecka, Andrzej Tomaszewski, Wojciech Brzozowski, Dorota Szczęśniak-Stańczyk, Krzysztof Duda and Andrzej Kutarski
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Anna Polewczyk: Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
Wojciech Jacheć: 2nd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
Dorota Nowosielecka: Department of Cardiology, The Pope John Paul II Province Hospital, 22-400 Zamość, Poland
Andrzej Tomaszewski: Department of Cardiology, Medical University of Lublin Poland, 20-059 Lublin, Poland
Wojciech Brzozowski: Department of Cardiology, Medical University of Lublin Poland, 20-059 Lublin, Poland
Dorota Szczęśniak-Stańczyk: Department of Cardiology, Medical University of Lublin Poland, 20-059 Lublin, Poland
Krzysztof Duda: Department of Cardiac Surgery, Masovian Specialistic Hospital, 26-617 Radom, Poland
Andrzej Kutarski: Department of Cardiology, Medical University of Lublin Poland, 20-059 Lublin, Poland

IJERPH, 2022, vol. 19, issue 19, 1-16

Abstract: Background: Damage to the tricuspid valve (TVD) is now considered either a major or minor complication of the transvenous lead extraction procedure (TLE). As yet, the risk factors and long-term survival after TLE in patients with TVD have not been analyzed in detail. Methods: This post hoc analysis used clinical data of 2631 patients (mean age 66.86 years, 39.64% females) who underwent TLE procedures performed in three high-volume centers. The risk factors and long-term survival of patients with worsening tricuspid valve (TV) function after TLE were analyzed. Results: In most procedures (90.31%), TLE had no negative influence on TV function, but in 9.69% of patients, a worsening of tricuspid regurgitation (TR) to varying degrees was noted, including significant dysfunction in 2.54% of patients. Risk factors of TLE relating to severe TVD were: TLE of pacing leads (5.264; p = 0.029), dwell time of the oldest extracted lead (OR = 1.076; p = 0.032), strong connective scar tissue connecting a lead with tricuspid apparatus (OR = 5.720; p < 0.001), and strong connective scar tissue connecting a lead with the right ventricle wall (OR = 8.312; p < 0.001). Long-term survival (1650 ± 1201 [1–5519] days) of patients with severe TR was comparable to patients without tricuspid damage related to TLE. Conclusions: Severe tricuspid valve damage related to TLE is relatively rare (2.5%). The main risk factors for the worsening of TV function are associated with a longer lead dwell time (more often the pacing lead), causing stronger connective tissue scars connecting the lead to the tricuspid apparatus and right ventricle. TVD is unlikely to affect long-term survival after TLE.

Keywords: transvenous lead extraction complications; tricuspid valve damage; risk factors; long-term survival (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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