The Journal of Thoracic and Cardiovascular Surgery
Congenital: Tricuspid ValveSurgical management of transvenous lead-induced tricuspid regurgitation in adult and pediatric patients with congenital heart disease
Graphical abstract
Section snippets
Study Design
The study included patients with CHD who underwent elective TV surgery for lead-induced TR between January 1, 1998, and December 31, 2015, at Mayo Clinic, Rochester, Minnesota. Lead-induced TR was determined by surgical inspection and/or echocardiography. The study was approved by the Mayo Foundation Institutional Review Board (16-006244; Aug 18, 2016). A waiver of informed consent was granted. Data from patients who provided general research authorization were included in the study.
Data Collection and Study Groups
Patients
Patients
Median age of the 54 patients was 48.2 years (IQR, 37.3-59.0 years); 31 were female (57.4%). This subset represented 3.9% of 1400 patients with CHD who underwent TV surgery for TR during the study period. The temporal distribution of included patients is shown in Figure E1. Lead-induced TR was documented in the surgeon's description for 40 patients (74.1%), identified on intraoperative TEE for 28 patients (51.9%), and preoperative echocardiography for 26 patients (48.2%).
Thirty patients (55.6%)
Discussion
Cardiac rhythm devices including PMs, ICDs, and CRTDs are used with increasing frequency to prevent and manage late arrhythmic complications in patients with repaired CHD. When the anatomy and patient size permit, a transvenous cardiac device is generally preferred. However, lead-induced TR remains a major concern, and there is little information concerning management of device-related TR in patients with CHD. Although the Micra TPS leadless PM was approved by the US Food and Drug
Conclusions
Patients with CHD who had lead-induced TR were young. Despite the need for concomitant cardiac procedures in most patients, early mortality was low (1.9%) after TV repair (3.3%) and replacement (0.0%). Overall survival and cumulative risk of TV reintervention at 5 years were both acceptable (80.4% and 2.4%, respectively). TV repair was associated with progressive TR during intermediate follow-up, particularly in patients who had preoperative severe TR. In the repair group, moderate or severe TR
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2023, International Journal of Cardiovascular ImagingTricuspid Annulus Dilation in Patients With Combined Functional Tricuspid Regurgitation and Left-Heart Valvular Disease: Does Septal Annulus Not Dilate?
2022, Frontiers in Cardiovascular Medicine
This study was supported by Dr Dearani’s Sheikh Zayed Professorship of Cardiovascular Diseases Honoring George M. Gura, MD.