JACC. Case reports · 2026
Emergent Tricuspid Valve Transcatheter Edge-to-Edge Repair Following Papillary Muscle Rupture During Lead Extraction.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Jang Jaejoon, Gamal Amr, Cheema Asim N, Coutinho Christopher J, Kim Daniel H, Larkin John, Bagai Akshay, Khaykin Yaariv, Cantor Warren J, Sadek Mouhannad M
Аннотация
BACKGROUND: Transvenous lead extraction carries a small risk of vascular tears and tricuspid valve (TV) damage.
CASE SUMMARY: A 68-year-old woman with dilated cardiomyopathy and a primary prevention cardiac resynchronization therapy with a defibrillator presented with device infection and was referred for system extraction. During the procedure, she developed acute hemodynamic instability due to an anterior papillary muscle rupture, resulting in a flail anterior TV leaflet and severe tricuspid regurgitation. Emergent TV transcatheter edge-to-edge repair was performed successfully within 48 hours.
DISCUSSION: This is the first reported case of flail TV leaflet secondary to papillary muscle rupture during transvenous lead extraction, managed successfully with emergent transcatheter edge-to-edge repair. This case highlights the critical role of percutaneous intervention in the management of iatrogenic TV injury.
TAKE-HOME MESSAGES: TV injury is a rare but life-threatening complication of lead extraction. Percutaneous valve repair is a viable option for critically ill or inoperable patients.
CASE SUMMARY: A 68-year-old woman with dilated cardiomyopathy and a primary prevention cardiac resynchronization therapy with a defibrillator presented with device infection and was referred for system extraction. During the procedure, she developed acute hemodynamic instability due to an anterior papillary muscle rupture, resulting in a flail anterior TV leaflet and severe tricuspid regurgitation. Emergent TV transcatheter edge-to-edge repair was performed successfully within 48 hours.
DISCUSSION: This is the first reported case of flail TV leaflet secondary to papillary muscle rupture during transvenous lead extraction, managed successfully with emergent transcatheter edge-to-edge repair. This case highlights the critical role of percutaneous intervention in the management of iatrogenic TV injury.
TAKE-HOME MESSAGES: TV injury is a rare but life-threatening complication of lead extraction. Percutaneous valve repair is a viable option for critically ill or inoperable patients.