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Tricuspid Valve Damage Related to Transvenous Lead Extraction

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...

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Autores principales: Polewczyk, Anna, Jacheć, Wojciech, Nowosielecka, Dorota, Tomaszewski, Andrzej, Brzozowski, Wojciech, Szczęśniak-Stańczyk, Dorota, Duda, Krzysztof, Kutarski, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566121/
https://www.ncbi.nlm.nih.gov/pubmed/36231579
http://dx.doi.org/10.3390/ijerph191912279
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author Polewczyk, Anna
Jacheć, Wojciech
Nowosielecka, Dorota
Tomaszewski, Andrzej
Brzozowski, Wojciech
Szczęśniak-Stańczyk, Dorota
Duda, Krzysztof
Kutarski, Andrzej
author_facet Polewczyk, Anna
Jacheć, Wojciech
Nowosielecka, Dorota
Tomaszewski, Andrzej
Brzozowski, Wojciech
Szczęśniak-Stańczyk, Dorota
Duda, Krzysztof
Kutarski, Andrzej
author_sort Polewczyk, Anna
collection PubMed
description 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.
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spelling pubmed-95661212022-10-15 Tricuspid Valve Damage Related to Transvenous Lead Extraction Polewczyk, Anna Jacheć, Wojciech Nowosielecka, Dorota Tomaszewski, Andrzej Brzozowski, Wojciech Szczęśniak-Stańczyk, Dorota Duda, Krzysztof Kutarski, Andrzej Int J Environ Res Public Health Article 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. MDPI 2022-09-27 /pmc/articles/PMC9566121/ /pubmed/36231579 http://dx.doi.org/10.3390/ijerph191912279 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Polewczyk, Anna
Jacheć, Wojciech
Nowosielecka, Dorota
Tomaszewski, Andrzej
Brzozowski, Wojciech
Szczęśniak-Stańczyk, Dorota
Duda, Krzysztof
Kutarski, Andrzej
Tricuspid Valve Damage Related to Transvenous Lead Extraction
title Tricuspid Valve Damage Related to Transvenous Lead Extraction
title_full Tricuspid Valve Damage Related to Transvenous Lead Extraction
title_fullStr Tricuspid Valve Damage Related to Transvenous Lead Extraction
title_full_unstemmed Tricuspid Valve Damage Related to Transvenous Lead Extraction
title_short Tricuspid Valve Damage Related to Transvenous Lead Extraction
title_sort tricuspid valve damage related to transvenous lead extraction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9566121/
https://www.ncbi.nlm.nih.gov/pubmed/36231579
http://dx.doi.org/10.3390/ijerph191912279
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