First case of pacemaker implantation in a patient with previous percutaneous edge-to-edge tricuspid valve repair

Vitali, Francesco; Malagù, Michele; Mele, Daniela; Rapezzi, Claudio; Bertini, Matteo

doi:10.1016/j.hrcr.2021.11.015

Cited by 5 publications

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did however cross the TV and position the PL TOE-guided, which we highly recommend. Since our first report on pacemaker implantation after T-TEER with the TriClip system, 8 other case reports 9 confirmed the feasibility of endovascular PL placement. Therefore, we see no reason why T-TEER patients with pacemaker indications should receive an epicardial PL.…”

Section: Discussionmentioning

confidence: 78%

Two ‘firsts’ in a patient with tricuspid valve infective endocarditis following edge-to-edge repair: a case report

Patrascu,

Binder,

Al Farwan

et al. 2024

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Tricuspid regurgitation (TR) is associated with increased morbidity and mortality. As many elderly TR patients are deemed inoperable, transcatheter edge-to-edge repair (T-TEER) is arising as a viable treatment option. Though procedural safety aspects seem excellent, long-term risks cannot be ignored, including the feasibility of cardiac pacing by endovascular lead implantation at a later time, as well as T-TEER device-related infective endocarditis (IE), in the context of systemic infection. Case summary We present the case of an 80-year-old man with recurrent admissions for right heart failure due to massive TR, despite successful percutaneous mitral valve repair. The patient was turned down for surgery and eventually underwent T-TEER, with successful TR reduction to mild-to-moderate and improvement in quality of life. Five months later, the patient was admitted for symptomatic bradycardia and the first reported pacemaker implantation after T-TEER with a specific tricuspid valve device was performed. Lead implantation was guided by transoesophageal echocardiography, and did not worsen residual TR. Two years later, the patient presented with device-related tricuspid valve IE, again a “first” following T-TEER. Despite antimicrobial therapy, the vegetation embolized through the atrial septal defect caused by prior mitral-TEER and triggered an ischemic stroke. Furthermore, sepsis led to multiorgan failure and eventually death. Discussion TR is an individual predictor of morbidity and mortality, frequently found in elderly, and should be addressed in symptomatic inoperable patients. With the rise of interventional treatment, new challenges face long-term follow-up and treatment after percutaneous repair. This case report underscores the feasibility of endovascular pacemaker lead implantation after T-TEER, while it points to the risk of device-related tricuspid valve IE.

show abstract

Section: Discussionmentioning

confidence: 78%