8 research outputs found
P1181Lead dependent tricuspid dysfunction- mechanism and treatment
Full text linkAbstract
Background
Lead dependent tricuspid dysfunction (LDTD) is a hardly recognizable severe complication of permanent cardiac pacing.
Purpose
Aim of the study was to assess the mechanism of lead dependent tricuspid dysfunction (LDTD) and effect of transvenous leads extraction (TLE) in theese patients.
Methods
We analyzed the clinical data of 3110 patients undergoing TLE from 01/2006 to 09/2019 in a single center. Echocardiographic assessment was performed in 2559 patients. LDTD mechanism and improvement of valve function after unblocking (by removing the lead) were analyzed.
Results
LDTD was recognized in 98 (7,3%) patients. The most common mechanism of LDTD was pulling up the leaflet of tricuspid valve by the lead. Improvement of tricuspid valve function was observed in all patients with recognized LDTD. 18 patients with slight improvement were directed to cardiosurgery after TLE.
Conclusions
LDTD should be considered in patients with implanted pacing system and severe tricuspid regurgitation. Transvenous leads extraction can improve function of tricuspid valve in theese patients.
Abstract Table
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P2854Floating connecting tissue scars ghosts after transvenous lead extraction
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Background
The phenomenon of appearance of connecting tissue remnants floating in vena cava (VC), right atrium (RA) tricuspid valve (TV), right ventricle (RV) or coronary sinus (CS) was described recently. Frequency of occurrence and their significance remain unknown. Till now, our knowledge is limited due lack exact description in the literature.
Purpose
The goal of this study was analysis of the appearance of this phenomenon using trans-esophageal echocardiography.
Methods
Between 2006 and January 2018 we performed 2408 TLE procedures using conventional mechanical sheaths. 3836 leads (mean implant duration 96,13 months) were extracted, mainly due to non-infective indications in 64,2%. Results of exact TEE before and after the procedure were available in 2034 patients. All patients with incomplete ECHO/TEE evaluation were excluded from the analysis.
Results
Results are presented in the table
Conclusions
In about 25% of patients after TLE floating connecting tissue scars can be observed. Most frequently they can be noted in VC (33%) RA (28%) and RV (10%). In 23% ghosts has numerous location in different combinations. Mean size of “ghosts” is about 20x4 mm. This phenomenon should be known for doctors who perform transesophageal echocardiography to avoid faulty diagnosis.
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P1182Asymptomatic masses on the pacing leads - influence on long term survival
Full text linkAbstract
Background
Asymptomatic Masses on Endocardiac Leads (AMELs) are relatively often found in echocardiography in patients with cardiac implantable electronic devices (CIED) but their clinical significance is unknown.
Purpose
Aim of the study was to evaluate the incidence of AMELs and assesment of their influence on long term survival (mean follow up- 4,28 ± 3,13 years) of patients undergoing transvenous leads extraction (TLE).
Methods
We analyzed the clinical data of patients undergoing TLE in single center in years 2006-2019. Echocardiography before TLE was performed in 2558 patients (60,4% male). AMELs were detected in 426 (16,7%) cases. Classifications of AMELs included connective tissue surronding the leads, clots, alike vegetations masses. Additionally, real vegetations, thickening of the leads and strong connective tissue scars were distinguished. Long term survival was compared between individual types of AMELs and patients without any additional masses on the leads.
Results are presented in the table.
Conclusion
Poor long-term survival was observed in patients with AMELs on the pacing leads.
Abstract Table
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P3135Tricuspid valve dysfunction caused by transvenous lead extraction. Can we predict this complication?
Full text linkAbstract
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.
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2407Influence of transvenous lead extraction procedure on function of tricuspid apparatus
Full text linkAbstract
Background
Accidental damage of tricuspid apparatus remain known complication of TLE procedure but our knowledge is limited due lack of separate analysis in the literature.
Purpose
The goal of this study was analysis of the appearance of lead extraction related tricuspid valve dysfunction using trans-chest and trans-oesophageal echocardiography.
Methods
Between March 2006 and December 2018 we performed 2900 TLE procedures using conventional mechanical sheaths in 1760 male and 1140 female patients (mean age 66.6y). 4811 leads (mean implant duration 91.5 months) were removed due to non-infective indications in 65.3%. Full radiological success was obtained in 95.7% procedures, partial in 4.0%, clinical success in 98.0%, full procedural success in 96.1%. Major complications (MC) appeared in 8 (1.8%).
Results
Results are presented in the table
Conclusions
TLE using conventional mechanical sheaths is effective. Tricuspid valve dysfunction different degree is frequent finding in candidates for TLE. TLE procedure brings risk (7.2%) of different degree damage of tricuspid leflet (significant in 1.5%) or even chordae tendinae (4%). Patients with severe lead extraction related tricuspid valve dysfunction needs exact follow-up and some of them can be candidates for cardiac surgery. On the other hand in not so rare cases of lead related tricuspid valve dysfunction – lead removal/replacement can to bring improvement of tricuspid valve function (6.1%).
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Poster Session 4The imaging examination and quality assessmentP957Economic impact analysis and quality performance of working with cardiovascular sonographers in high-volume echocardiography laboratoryP958Feasibility of temporal super resolution enhancement of echocardiographic images to diagnose cardiac DiseasesP959Remote medical diagnostician project - Achievements and limitation in tele-echocardiographyP960Right atrial remodeling and galectin-3 are associated with functional capacity in patients with pulmonary arterial hypertensionP961Interatrial electromechanical delay assessed by tissue doppler imaging can separate adults with prehypertension from healthy normotensive controlsP962Preliminary results of an extensive echocardiographic pacemaker optimization protocol for cardiac resynchronization therapyP963Left ventricular global and regional myocardial function in patients with double orifice mitral valve after radical correction on atrioventricular septal defectP964Improving quantitation of left ventricular ejection fraction in a tertiary echocardiography lab - marrying (or merging) guidelines and new technologyP965Echocardiographic evaluation of cardiac function and hemodynamics during LVAD-based resuscitation from cardiac arrest - a porcine studyP966Systolic excursion of the right ventricular outflow tract as a marker of right ventricular dysfunctionP967The impact of the new 2016 ASE/EACVI recommendations in the prevalence and grades of diastolic dysfunction: an analysis from the general populationP968Differential microRNA-21 and microRNA-133 gene expression levels in peripheral blood mononuclear cells from patients with heart failure with preserved ejection fractionP969CMR evaluation of cardiac thrombi and masses by T1 and T2 mapping : an observational studyP970Effect of coronary artery ectasia on left ventricular deformation mechanics. A 2D Speckle Tracking Echocardiography studyP971Diagnostic performance of stress Echo, SPECT, PET, stress CMR, CTCA, CTP and FFRCT for the assessment of CAD versus invasive FFR: a metaanalysisP972Utility of early assessment of myocardial mechanics in STEMI patients treated by primary percutaneous coronary intervention to predict major adverse cardiac events during the first 12 months of folloP973Role of left atrial reservoir in the prediction of increased left ventricular filling pressures in patients with ST-segment elevation myocardial infarctionP974Does the left ventricle ejection fraction improves the Grace risk score accuracy? P975Can we predict significant coronary stenosis using regional strain analysis in non-ST elevation acute coronary syndrome?P976Persistence of pulmonary hypertension after transcatheter aortic valve replacement: incidence and prognostic impactP977Global longitudinal strain is an independent predictor of all cause mortality in patients with severe aortic valve stenosis undergoing valve replacement or treated conservativallyP978Contribution of left ventricular diastolic dysfunction and myocardial fibrosis to pulmonary hypertension in severe aortic stenosisP979Left atrial dysfunction as a determinant of pulmonary hypertension in patients with isolated severe aortic stenosis and preserved left ventricular ejection fractionP980Intraprocedural monitoring protocol using routine transthoracic echocardiography with backup transesophageal probe in transcatheter aortic valve replacement: a single center experience
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