Severe Tricuspid Regurgitation Due to Entrapment of the Anterior Leaflet of the Valve by a Permanent Pacemaker Lead: Role of Real Time Three‐Dimensional Echocardiography

Nucifora, Gaetano; Badano, Luigi P.; Allocca, Giuseppe; Gianfagna, Pasquale; Proclemer, Alessandro; Cinello, Margherita; Fioretti, P.

doi:10.1111/j.1540-8175.2007.00443.x

Cited by 35 publications

(26 citation statements)

References 12 publications

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“…Mechanisms that have been reported previously include obstruction to leaflet closing, perforation, and laceration. [1][2][3][4][5]12,13 Lin et al 7 found that PPM-related tricuspid malfunctions were caused by various mechanisms; the largest subset of patients (39%) had lead impingement only of the tricuspid valve leaflets at surgery, but other mechanisms included adhesion of the PPM or ICD lead to a tricuspid valve leaflet (34%), leaflet perforation (17%), and entanglement of the tricuspid valve apparatus (10%). On that basis, insufficient valve closure may be the main cause of PPM-lead-related TR, as shown by our data.…”

Section: Mechanism Of Lead-related Trmentioning

confidence: 99%

“…7 The 3-dimensional echocardiography (3-DE) has been recently developed for assessing tricuspid valve morphology and pathology, including TR, [8][9][10][11] and case reports on its utility in the diagnosis of PPM-and ICD-lead-related TR have been published. 12,13 However, the ability of 3-DE to identify both the anatomical lead route through the tricuspid valve and lead-induced valve malfunction has not been studied systematically. …”

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confidence: 99%

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Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker Leads

Seo

Ishizu

Nakajima

et al. 2008

Circ J

111

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ignificant tricuspid regurgitation (TR) has been reported in patients with a permanent pacemaker (PPM), [1][2][3][4][5] and the leads of such a device or those of an implantable cardioverter defibrillator (ICD) can be the primary cause of symptomatic TR. 6,7 However, in the clinical setting, the diagnosis of lead-induced TR can be challenging because conventional 2-dimensional echocardiography (2-DE) has limitations in identifying the anatomical relationship between the lead and the tricuspid leaflets. 7 The 3-dimensional echocardiography (3-DE) has been recently developed for assessing tricuspid valve morphology and pathology, including TR, [8][9][10][11] and case reports on its utility in the diagnosis of PPM-and ICD-lead-related TR have been published. 12,13 However, the ability of 3-DE to identify both the anatomical lead route through the tricuspid valve and lead-induced valve malfunction has not been studied systematically. Methods Patient PopulationIn 87 patients with PPM, ICD or cardiac resynchroniza- Circulation Journal Vol.72, September 2008tion therapy device, 3-DE studies were performed to evaluate the route of the leads and the presence of lead-related TR (Table 1). The underlying cardiac disease for which PPM implantation was required was complete or advanced atrioventricular block in 28 patients and sick sinus syndrome, including slow atrial fibrillation, in 22 patients, and for ICD implantation it was primary or secondary prevention of fatal cardiac arrhythmias in 17 patients. Cardiac resynchronization therapy devices with or without ICD were implanted in 20 patients with advanced heart failure. The study was approved by the local research ethics committee, and all patients gave written informed consent. Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker LeadsYoshihiro Seo, MD; Tomoko Ishizu, MD; Hideki Nakajima, RDCS*; Yukio Sekiguchi, MD; Shigeyuki Watanabe, MD; Kazutaka Aonuma, MD Background This study evaluated the usefulness of 3-dimensional echocardiography (3-DE) for identifying permanent pacemaker (PPM) or implantable cardioverter defibrillator (ICD) lead-related symptomatic tricuspid regurgitation (TR). Methods and ResultsEighty-seven patients underwent 3-DE examination: 50 patients with PPM, 17 with ICD, and 20 with cardiac resynchronization therapy devices. TR severity was classified as trivial/mild, moderate, or severe according to the ratio of TR area to right atrium area. The 3-DE identified the lead route and position at the tricuspid valve in 82 patients (94.2%). In 5 patients, images without lead-induced artifacts could not be obtained. TR severity was trivial/mild in 50 patients, moderate in 20 patients, and severe in 12 patients. In all patients with trivial/mild TR and all but 1 patient with moderate TR, leads were positioned on the annulus side between leaflets. Lead-induced obstruction to tricuspid valve closing was identified in 1 patient with moderate TR and in 7 of 12 patients with severe TR: 4 patients had...

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Section: Mechanism Of Lead-related Trmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker Leads

Seo

Ishizu

Nakajima

et al. 2008

Circ J

111

View full text Add to dashboard Cite

show abstract

“…Так, в исследовании G. Lin et al перфорация створки электродом или ее повреждение на обычной трансторакальной 2D-эхокардиографии были выявлены лишь у 12% пациентов [10]. Для более детальной оценки по-ложения электрода и состояния клапанного ап-парата используется трансторакальная 3D-эхо-кардиография [11].…”

Section: имплантация антиаритмических устройств является методом выбоunclassified

“…экстракций электродов [34]. Экс-тракция хронически имплантированных элект-родов является комплексным, малотравматич-ным и высокоэффективным методом лечения в крупных и высокоспециализированных цент-рах, но может сопровождаться фатальными осложнениями [11]. Необходимо отметить, что количество осложнений при данном виде мани-пуляций из года в год становится меньше и со-ставляет примерно 0,4-1% [33].…”

Section: имплантация антиаритмических устройств является методом выбоunclassified

Tricuspid Valve Regurgitation After Antiarrhythmic Device Implantation

Кропоткин¹,

Ivanitskiy²

2017

Ann aritmol

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“…The en face view of the TV may assist in the diagnosis of TV variants such as the presence of a bileaflet TV which has only been described using 3D-TTE [54]. 3D echocardiography can be helpful in identifying whether pacemaker or intracardiac defibrillator leads contribute to tricuspid regurgitation [55]. Further, 3D color flow Doppler showed that the TV VC is more of an elliptic shape compared to the MV [56].…”

Section: Tricuspid and Pulmonic Valvesmentioning

confidence: 99%

Evolving Role of Three-Dimensional Echocardiography in the Cardiac Surgical Patient

Ferreira

Choi

Mackensen

2013

Curr Anesthesiol Rep

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The first human three-dimensional transesophageal echocardiography (3D TEE) was reported in 1992. Ever since, technologic advances have revolutionized this echocardiographic imaging modality. Today, real-time 3D TEE (RT-3D TEE) represents a novel clinical and intuitively educational perioperative cardiovascular imaging tool. In addition, live 3D TEE adds significantly to the perioperative communication between cardiac surgeons and echocardiographer. Its unique ability of real-time acquisition and accurate identification of precise cardiac pathology, together with its ability to promptly quantify 3D datasets using builtin software, has greatly helped to transition 3D TEE into the standard of perioperative care. The recent development of percutaneous procedures such as valve implantations and repairs also benefit from 3D TEE quantification and guidance. This article reviews the available 3D TEE acquisition modes, newest advances in 3D technology, and the utility of 3D TEE in different settings of cardiac procedures.

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Severe Tricuspid Regurgitation Due to Entrapment of the Anterior Leaflet of the Valve by a Permanent Pacemaker Lead: Role of Real Time Three‐Dimensional Echocardiography

Cited by 35 publications

References 12 publications

Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker Leads

Clinical Utility of 3-Dimensional Echocardiography in the Evaluation of Tricuspid Regurgitation Caused by Pacemaker Leads

Tricuspid Valve Regurgitation After Antiarrhythmic Device Implantation

Evolving Role of Three-Dimensional Echocardiography in the Cardiac Surgical Patient

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