De Meester Pieter, Budts Werner, Gewillig Marc
Department of Congenital Cardiology, University Hospitals Leuven, Leuven, Belgium.
Catheter Cardiovasc Interv. 2014 Dec 1;84(7):1148-52. doi: 10.1002/ccd.25451. Epub 2014 Feb 27.
Although feasibility and efficacy of percutaneous tricuspid valve-in-valve implantation have been established, a transtricuspid pacing or defibrillator lead might preclude this technique: lead damage can cause lead dysfunction resulting in inappropriate or inefficient pacing or shocks. In these cases, lead removal is thought to be the only option. We describe a patient who presented with rapid clinical deterioration due to tricuspid valve stenosis early after implantation of an internal defibrillator with a transvalvular shock-lead. A transvenous valve-in-valve implantation of the tricuspid valve was performed after protecting the defibrillator-lead with a custom-made covered stent. We describe the technical issues, the clinical outcome, and the evolution of lead function after implantation.
尽管经皮三尖瓣瓣中瓣植入术的可行性和有效性已得到证实，但经三尖瓣起搏或除颤导线可能会妨碍该技术的应用：导线损伤可导致导线功能障碍，从而引起不适当或无效的起搏或电击。在这些情况下，取出导线被认为是唯一的选择。我们描述了一名患者，在植入带跨瓣除颤导线的体内除颤器后不久，因三尖瓣狭窄出现临床快速恶化。在用定制的覆膜支架保护除颤导线后，进行了经静脉三尖瓣瓣中瓣植入术。我们描述了植入后的技术问题、临床结果以及导线功能的演变。
