{
  "abstract": "Background Transcatheter tricuspid valve replacement (TTVR) has emerged as an effective treatment in addition to medical therapy in severe or greater tricuspid regurgitation (TR). Patients undergoing orthotopic TTVR frequently present with a cardiac implantable electronic device (CIED) lead across the tricuspid valve (TV).Aims We sought to investigate the clinical, procedural and lead-related outcomes for patients with a CIED lead across the TV during orthotopic TTVR.Methods All consecutive patients enrolled in the multicenter TRIPLACE registry ( NCT06033274) were included for analysis. TTVR was performed at 19 centers using 8 different platforms between June 2018 and April 2025. 60 patients had sufficient data allowing lead function parameter analysis. Lead failure was defined as structural or electrical malfunction requiring new lead or CIED insertion.Results Baseline demographic, clinical, procedural and CIED lead characteristics are outlined in table 1. Procedural, follow-up and CIED lead outcome data are outlined in table 2. Among 395 patients, 104 (26.3%) had transvalvular CIED leads. Procedural success, symptomatic improvement, and 30-day mortality were comparable between those with and without CIED. Patients with CIED leads had lower rates of mild or less residual TR (82.6% vs. 91.4%, p<0.041) and higher rates of moderate or greater paravalvular leak (17.1% vs. 7.1%, p<0.017). Lead failure occurred in 5.8% over a median follow-up time of 183 days, with modest changes in pacing thresholds. Univariable Fine-Gray competing risks regression analysis results, identifying predictors of lead failure, are outlined in table 3. No significant increase in adverse events or mortality was observed at 30 days.Abstract 29 Table 1Abstract 29 Table 2Abstract 29 Table 3Conclusion Orthotopic TTVR in patients can be safely and effectively performed in the presence of a transvalvular CIED lead with low rates of lead failure. Significant paravalvular leak and residual TR is more common with a jailed lead. These patients require close CIED follow up with alternative pacing strategies in place, particularly when pacing dependent.",
  "authors": [
    {
      "affiliations": [
        "Division of Cardiology, Toronto Heart Center, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "BP Traynor"
    },
    {
      "affiliations": [
        "Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA"
      ],
      "name": "A Scotti"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA"
      ],
      "name": "R Puri"
    },
    {
      "affiliations": [
        "Oregon Health and Science University, Portland, Oregon, USA"
      ],
      "name": "M Sturla"
    },
    {
      "affiliations": [
        "Oregon Health and Science University, Portland, Oregon, USA"
      ],
      "name": "F Zahr"
    },
    {
      "affiliations": [
        "Centre for Heart Valve Innovation, St. Paul’s Hospital, Vancouver, British Columbia, Canada"
      ],
      "name": "R Boone"
    },
    {
      "affiliations": [
        "Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA"
      ],
      "name": "S Kodali"
    },
    {
      "affiliations": [
        "Groupe Cardio-Vasculaire lnterventionnel, Cinique Pasteur, Toulouse, France"
      ],
      "name": "D Tchétché"
    },
    {
      "affiliations": [
        "The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark"
      ],
      "name": "O De Backer"
    },
    {
      "affiliations": [
        "University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1011-EGID, Lille, France",
        "Cardiovascular Research Foundation, New York, New York, USA"
      ],
      "name": "A Coisne"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany",
        "Department of Cardiology and Cardio-Vascular Surgery, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital, Pessac, France"
      ],
      "name": "S Ludwig"
    },
    {
      "affiliations": [
        "Medical Clinic and Polyclinic I, Ludwig-Maximilians University Hospital of Munich, Munich, Germany",
        "German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany"
      ],
      "name": "L Stolz"
    },
    {
      "affiliations": [
        "Interventional Cardiology Clinic, University Hospital Alvaro Cunqueiro, Vigo, Spain"
      ],
      "name": "R Estevez Loureiro"
    },
    {
      "affiliations": [
        "Heart Center Cologne, University of Cologne, Cologne, Germany"
      ],
      "name": "M Adam"
    },
    {
      "affiliations": [
        "Centro Cardiologico Monzino IRCCS, Milan, Italy"
      ],
      "name": "F De Marco"
    },
    {
      "affiliations": [
        "Centro Cardiologico Monzino IRCCS, Milan, Italy"
      ],
      "name": "M Biroli"
    },
    {
      "affiliations": [
        "Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA"
      ],
      "name": "EC Ho"
    },
    {
      "affiliations": [
        "Centre for Heart Valve Innovation, St. Paul’s Hospital, Vancouver, British Columbia, Canada"
      ],
      "name": "A Cheung"
    },
    {
      "affiliations": [
        "Division of Cardiology, Toronto Heart Center, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "A Patrascu"
    },
    {
      "affiliations": [
        "Division of Cardiology, Toronto Heart Center, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "S Alnasser"
    },
    {
      "affiliations": [
        "Oregon Health and Science University, Portland, Oregon, USA"
      ],
      "name": "S Chadderdon"
    },
    {
      "affiliations": [
        "The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark"
      ],
      "name": "D Lulic"
    },
    {
      "affiliations": [
        "Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA"
      ],
      "name": "J Bartkowiak"
    },
    {
      "affiliations": [
        "Interventional Cardiology Clinic, University Hospital Alvaro Cunqueiro, Vigo, Spain"
      ],
      "name": "J Echarte"
    },
    {
      "affiliations": [
        "Division of Cardiology, Cardiovascular Center Frankfurt, Frankfurt am Main, Germany"
      ],
      "name": "H Sievert"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic Surgery and Interventional Cardiology, Arizona Heart Hospital, Phoenix, Arizona, USA"
      ],
      "name": "T Byrne"
    },
    {
      "affiliations": [
        "Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy"
      ],
      "name": "F Maisano"
    },
    {
      "affiliations": [
        "University Heart Center, Schleswig-Holstein University, Lübeck, Germany"
      ],
      "name": "C Frerker"
    },
    {
      "affiliations": [
        "Groupe Cardio-Vasculaire lnterventionnel, Cinique Pasteur, Toulouse, France"
      ],
      "name": "N Dumonteil"
    },
    {
      "affiliations": [
        "Groupe Cardio-Vasculaire lnterventionnel, Cinique Pasteur, Toulouse, France"
      ],
      "name": "OA Oliva"
    },
    {
      "affiliations": [
        "General and Interventional Cardiology/Angiology, Heart and Diabetes Centre, North Rhine-Westphalia, Ruhr-University, Bad Oeynhausen, Germany"
      ],
      "name": "TK Rudolph"
    },
    {
      "affiliations": [
        "General and Interventional Cardiology/Angiology, Heart and Diabetes Centre, North Rhine-Westphalia, Ruhr-University, Bad Oeynhausen, Germany"
      ],
      "name": "J Kirchner"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA"
      ],
      "name": "B Bakhtadze"
    },
    {
      "affiliations": [
        "Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA"
      ],
      "name": "SR Kapadia"
    },
    {
      "affiliations": [
        "Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada"
      ],
      "name": "J del Portillo"
    },
    {
      "affiliations": [
        "Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada"
      ],
      "name": "J Rodés-Cabau"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Heart and Vascular Center, Hamburg, Germany"
      ],
      "name": "N Schofer"
    },
    {
      "affiliations": [
        "Cardiovascular Research Foundation, New York, New York, USA"
      ],
      "name": "J Granada"
    },
    {
      "affiliations": [
        "Medical Clinic and Polyclinic I, Ludwig-Maximilians University Hospital of Munich, Munich, Germany",
        "German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany"
      ],
      "name": "J Hausleiter"
    },
    {
      "affiliations": [
        "Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA"
      ],
      "name": "RT Hahn"
    },
    {
      "affiliations": [
        "Department of Cardiology and Cardio-Vascular Surgery, Hopital Cardiologique de Haut-Leveque, Bordeaux University Hospital, Pessac, France"
      ],
      "name": "T Modine"
    },
    {
      "affiliations": [
        "Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA"
      ],
      "name": "A Latib"
    },
    {
      "affiliations": [
        "Division of Cardiology, Toronto Heart Center, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "N Fam"
    }
  ],
  "title": "29 Outcomes following orthotopic transcatheter tricuspid valve replacement in patients with cardiac implantable electronic device endocardial leads: the triplace registry",
  "uid": "2a167452-d687-5cda-9172-4fe39ab49116"
}