Tricuspid valve dysfunction caused by transvenous lead extraction. Can we predict this complication?

Abstract Background Accidental damage of tricuspid apparatus is known complication of TLE procedure risk factors of this complication remain unknown. Purpose The goal of this study was to search factors which can predict damage of tricuspid apparatus during TLE. Methods Between 2006 and 2018 we performed 2002 TLE procedures using conventional mechanical sheaths. 3366 leads (mean implant duration 95,2 months) were removed due to non-infective indications in 62,0%. Tricuspid valve function was examined with preoperative and post-operative TTE and during monitoring of procedure. Patients with incomplete TV function evaluation were excluded from the study. Three groups of patients were compared Results TLE procedure brings risk (7%) of different degree damage or tricuspid leflet or even chordae tendinae (2%). The detailed results are presented in the table. Conclusions TLE using conventional mechanical sheaths is effective but brings risk of extraction related tricuspid valve dysfunction. Main risk factor of this complication seems to be implant dwell time, number of leads presence of abandoned leads and lead loop in the heart remaining in conflict with tricuspid valve.