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Tricuspid Valve Damage Related to Transvenous Lead Extraction

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  • Anna Polewczyk

    (Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
    Department of Cardiac Surgery, Świętokrzyskie Center of Cardiology, 25-736 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)

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.

Suggested Citation

  • Anna Polewczyk & Wojciech Jacheć & Dorota Nowosielecka & Andrzej Tomaszewski & Wojciech Brzozowski & Dorota Szczęśniak-Stańczyk & Krzysztof Duda & Andrzej Kutarski, 2022. "Tricuspid Valve Damage Related to Transvenous Lead Extraction," IJERPH, MDPI, vol. 19(19), pages 1-16, September.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:19:p:12279-:d:926994
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    References listed on IDEAS

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    1. Łukasz Tułecki & Anna Polewczyk & Wojciech Jacheć & Dorota Nowosielecka & Konrad Tomków & Paweł Stefańczyk & Jarosław Kosior & Krzysztof Duda & Maciej Polewczyk & Andrzej Kutarski, 2021. "Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage," IJERPH, MDPI, vol. 18(17), pages 1-13, August.
    2. Łukasz Tułecki & Anna Polewczyk & Wojciech Jacheć & Dorota Nowosielecka & Konrad Tomków & Paweł Stefańczyk & Jarosław Kosior & Krzysztof Duda & Maciej Polewczyk & Andrzej Kutarski, 2021. "A Study of Major and Minor Complications of 1500 Transvenous Lead Extraction Procedures Performed with Optimal Safety at Two High-Volume Referral Centers," IJERPH, MDPI, vol. 18(19), pages 1-13, October.
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