Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices

Kent Chak-Yu So; Lukas Stolz; Neil Fam; Geraldine Ong; Anson Cheung; Robert Boone; Pedro Villablanca; Ahmad Jabri; Yat-Yin Lam; Didier Tchétché; Omar Oliva; Ole De Backer; Jacob Eifer Mølller; Azeem Latib; Andrea Scotti; Augustin Coisne; Arnaud Sudre; Julien Dreyfus; Mohammed Nejjari; Paul-Emile Favre; Ignacio Cruz-Gonzalez; Rodrigo Estévez-Loureiro; Manuel Barreiro-Perez; Raj Makkar; Dhairya Patel; Guillaume Leurent; Erwan Donal; Thomas Modine; Jörg Hausleiter

doi:10.1016/j.jacasi.2025.07.009

Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices

Kent Chak-Yu So^*, Lukas Stolz, Neil Fam, Geraldine Ong, Anson Cheung, Robert Boone, Pedro Villablanca, Ahmad Jabri, Yat-Yin Lam, Didier Tchétché, Omar Oliva, Ole De Backer, Jacob Eifer Mølller, Azeem Latib, Andrea Scotti, Augustin Coisne, Arnaud Sudre, Julien Dreyfus, Mohammed Nejjari, Paul-Emile FavreIgnacio Cruz-Gonzalez, Rodrigo Estévez-Loureiro, Manuel Barreiro-Perez, Raj Makkar, Dhairya Patel, Guillaume Leurent, Erwan Donal, Thomas Modine, Jörg Hausleiter^*

^*Corresponding author af dette arbejde

Afdeling for Hjertesygdomme HJE

1 Citationer (Scopus)

Abstract

BACKGROUND: Cardiac implantable electronic device (CIED)-related tricuspid regurgitation (TR) is common. Transcatheter tricuspid valve replacement (TTVR) is feasible with CIEDs in the right ventricle; however, data in this population are limited.

OBJECTIVES: This study retrospectively analyzed patients undergoing compassionate-use transjugular TTVR with the LuX-Valve Plus for symptomatic TR with CIEDs from January 2022 to August 2024 at 17 international centers.

METHODS: The primary endpoint was procedural TR reduction. Secondary endpoints included TR reduction, survival at 30 days, NYHA functional class changes, and CIED function at follow-up. Non-CIED group was used for comparison.

RESULTS: Of 99 patients, 36 (36.4%) had CIEDs. Baseline characteristics were similar, though the CIED group had a higher EuroSCORE (European System for Cardiac Operative Risk Evaluation) II score and more comorbidities. Procedural success (CIED vs non-CIED: 91.7% vs 95.2%; P = 0.781), 30-day mortality (5.6% vs 4.8%; P > 0.999), TR reduction (≤1+: 83.8% vs 84.9%; P > 0.999), and NYHA functional class I/II (80.8% vs 83.7%; P = 0.89) were comparable. The CIED cohort exhibited a higher numerical incidence of conversion to surgery (8.3% vs 1.6%) and tricuspid reintervention (11.5% vs 3.3%) within 6 months; however, these differences did not reach statistical significance (P = 0.267 and P = 0.160, respectively). Of the 22 patients with postoperative interrogation (median of 3.3 months), 9.1% of CIED patients exhibited worsening device parameters, with no need for lead replacement or extraction.

CONCLUSIONS: Transjugular TTVR is safe and effective for managing TR and heart failure in patients with CIEDs. Due to the small sample size, these findings highlight the need for larger, prospective studies to validate these outcomes.

Originalsprog	Engelsk
Tidsskrift	JACC. Asia
Vol/bind	5
Udgave nummer	10
Sider (fra-til)	1260-1269
Antal sider	10
ISSN	2772-3747
DOI	https://doi.org/10.1016/j.jacasi.2025.07.009
Status	Udgivet - okt. 2025

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10.1016/j.jacasi.2025.07.009Licens: CC BY

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So, K. C.-Y., Stolz, L., Fam, N., Ong, G., Cheung, A., Boone, R., Villablanca, P., Jabri, A., Lam, Y.-Y., Tchétché, D., Oliva, O., De Backer, O., Mølller, J. E., Latib, A., Scotti, A., Coisne, A., Sudre, A., Dreyfus, J., Nejjari, M., ... Hausleiter, J. (2025). Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices. JACC. Asia, 5(10), 1260-1269. https://doi.org/10.1016/j.jacasi.2025.07.009

So, KC-Y, Stolz, L, Fam, N, Ong, G, Cheung, A, Boone, R, Villablanca, P, Jabri, A, Lam, Y-Y, Tchétché, D, Oliva, O, De Backer, O, Mølller, JE, Latib, A, Scotti, A, Coisne, A, Sudre, A, Dreyfus, J, Nejjari, M, Favre, P-E, Cruz-Gonzalez, I, Estévez-Loureiro, R, Barreiro-Perez, M, Makkar, R, Patel, D, Leurent, G, Donal, E, Modine, T & Hausleiter, J 2025, 'Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices', JACC. Asia, bind 5, nr. 10, s. 1260-1269. https://doi.org/10.1016/j.jacasi.2025.07.009

@article{8128c5020b654cae9eb6d065993b8f85,

title = "Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices",

abstract = "BACKGROUND: Cardiac implantable electronic device (CIED)-related tricuspid regurgitation (TR) is common. Transcatheter tricuspid valve replacement (TTVR) is feasible with CIEDs in the right ventricle; however, data in this population are limited.OBJECTIVES: This study retrospectively analyzed patients undergoing compassionate-use transjugular TTVR with the LuX-Valve Plus for symptomatic TR with CIEDs from January 2022 to August 2024 at 17 international centers.METHODS: The primary endpoint was procedural TR reduction. Secondary endpoints included TR reduction, survival at 30 days, NYHA functional class changes, and CIED function at follow-up. Non-CIED group was used for comparison.RESULTS: Of 99 patients, 36 (36.4%) had CIEDs. Baseline characteristics were similar, though the CIED group had a higher EuroSCORE (European System for Cardiac Operative Risk Evaluation) II score and more comorbidities. Procedural success (CIED vs non-CIED: 91.7% vs 95.2%; P = 0.781), 30-day mortality (5.6% vs 4.8%; P > 0.999), TR reduction (≤1+: 83.8% vs 84.9%; P > 0.999), and NYHA functional class I/II (80.8% vs 83.7%; P = 0.89) were comparable. The CIED cohort exhibited a higher numerical incidence of conversion to surgery (8.3% vs 1.6%) and tricuspid reintervention (11.5% vs 3.3%) within 6 months; however, these differences did not reach statistical significance (P = 0.267 and P = 0.160, respectively). Of the 22 patients with postoperative interrogation (median of 3.3 months), 9.1% of CIED patients exhibited worsening device parameters, with no need for lead replacement or extraction.CONCLUSIONS: Transjugular TTVR is safe and effective for managing TR and heart failure in patients with CIEDs. Due to the small sample size, these findings highlight the need for larger, prospective studies to validate these outcomes.",

keywords = "cardiac implantable electronic device, transcatheter lead extraction, transcatheter tricuspid valve replacement, tricuspid regurgitation",

author = "So, {Kent Chak-Yu} and Lukas Stolz and Neil Fam and Geraldine Ong and Anson Cheung and Robert Boone and Pedro Villablanca and Ahmad Jabri and Yat-Yin Lam and Didier Tch{\'e}tch{\'e} and Omar Oliva and {De Backer}, Ole and M{\o}lller, {Jacob Eifer} and Azeem Latib and Andrea Scotti and Augustin Coisne and Arnaud Sudre and Julien Dreyfus and Mohammed Nejjari and Paul-Emile Favre and Ignacio Cruz-Gonzalez and Rodrigo Est{\'e}vez-Loureiro and Manuel Barreiro-Perez and Raj Makkar and Dhairya Patel and Guillaume Leurent and Erwan Donal and Thomas Modine and J{\"o}rg Hausleiter",

year = "2025",

month = oct,

doi = "10.1016/j.jacasi.2025.07.009",

language = "English",

volume = "5",

pages = "1260--1269",

journal = "JACC. Asia",

issn = "2772-3747",

publisher = "Elsevier Inc.",

number = "10",

}

TY - JOUR

T1 - Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices

AU - So, Kent Chak-Yu

AU - Stolz, Lukas

AU - Fam, Neil

AU - Ong, Geraldine

AU - Cheung, Anson

AU - Boone, Robert

AU - Villablanca, Pedro

AU - Jabri, Ahmad

AU - Lam, Yat-Yin

AU - Tchétché, Didier

AU - Oliva, Omar

AU - De Backer, Ole

AU - Mølller, Jacob Eifer

AU - Latib, Azeem

AU - Scotti, Andrea

AU - Coisne, Augustin

AU - Sudre, Arnaud

AU - Dreyfus, Julien

AU - Nejjari, Mohammed

AU - Favre, Paul-Emile

AU - Cruz-Gonzalez, Ignacio

AU - Estévez-Loureiro, Rodrigo

AU - Barreiro-Perez, Manuel

AU - Makkar, Raj

AU - Patel, Dhairya

AU - Leurent, Guillaume

AU - Donal, Erwan

AU - Modine, Thomas

AU - Hausleiter, Jörg

PY - 2025/10

Y1 - 2025/10

N2 - BACKGROUND: Cardiac implantable electronic device (CIED)-related tricuspid regurgitation (TR) is common. Transcatheter tricuspid valve replacement (TTVR) is feasible with CIEDs in the right ventricle; however, data in this population are limited.OBJECTIVES: This study retrospectively analyzed patients undergoing compassionate-use transjugular TTVR with the LuX-Valve Plus for symptomatic TR with CIEDs from January 2022 to August 2024 at 17 international centers.METHODS: The primary endpoint was procedural TR reduction. Secondary endpoints included TR reduction, survival at 30 days, NYHA functional class changes, and CIED function at follow-up. Non-CIED group was used for comparison.RESULTS: Of 99 patients, 36 (36.4%) had CIEDs. Baseline characteristics were similar, though the CIED group had a higher EuroSCORE (European System for Cardiac Operative Risk Evaluation) II score and more comorbidities. Procedural success (CIED vs non-CIED: 91.7% vs 95.2%; P = 0.781), 30-day mortality (5.6% vs 4.8%; P > 0.999), TR reduction (≤1+: 83.8% vs 84.9%; P > 0.999), and NYHA functional class I/II (80.8% vs 83.7%; P = 0.89) were comparable. The CIED cohort exhibited a higher numerical incidence of conversion to surgery (8.3% vs 1.6%) and tricuspid reintervention (11.5% vs 3.3%) within 6 months; however, these differences did not reach statistical significance (P = 0.267 and P = 0.160, respectively). Of the 22 patients with postoperative interrogation (median of 3.3 months), 9.1% of CIED patients exhibited worsening device parameters, with no need for lead replacement or extraction.CONCLUSIONS: Transjugular TTVR is safe and effective for managing TR and heart failure in patients with CIEDs. Due to the small sample size, these findings highlight the need for larger, prospective studies to validate these outcomes.

AB - BACKGROUND: Cardiac implantable electronic device (CIED)-related tricuspid regurgitation (TR) is common. Transcatheter tricuspid valve replacement (TTVR) is feasible with CIEDs in the right ventricle; however, data in this population are limited.OBJECTIVES: This study retrospectively analyzed patients undergoing compassionate-use transjugular TTVR with the LuX-Valve Plus for symptomatic TR with CIEDs from January 2022 to August 2024 at 17 international centers.METHODS: The primary endpoint was procedural TR reduction. Secondary endpoints included TR reduction, survival at 30 days, NYHA functional class changes, and CIED function at follow-up. Non-CIED group was used for comparison.RESULTS: Of 99 patients, 36 (36.4%) had CIEDs. Baseline characteristics were similar, though the CIED group had a higher EuroSCORE (European System for Cardiac Operative Risk Evaluation) II score and more comorbidities. Procedural success (CIED vs non-CIED: 91.7% vs 95.2%; P = 0.781), 30-day mortality (5.6% vs 4.8%; P > 0.999), TR reduction (≤1+: 83.8% vs 84.9%; P > 0.999), and NYHA functional class I/II (80.8% vs 83.7%; P = 0.89) were comparable. The CIED cohort exhibited a higher numerical incidence of conversion to surgery (8.3% vs 1.6%) and tricuspid reintervention (11.5% vs 3.3%) within 6 months; however, these differences did not reach statistical significance (P = 0.267 and P = 0.160, respectively). Of the 22 patients with postoperative interrogation (median of 3.3 months), 9.1% of CIED patients exhibited worsening device parameters, with no need for lead replacement or extraction.CONCLUSIONS: Transjugular TTVR is safe and effective for managing TR and heart failure in patients with CIEDs. Due to the small sample size, these findings highlight the need for larger, prospective studies to validate these outcomes.

KW - cardiac implantable electronic device

KW - transcatheter lead extraction

KW - transcatheter tricuspid valve replacement

KW - tricuspid regurgitation

UR - http://www.scopus.com/inward/record.url?scp=105016821405&partnerID=8YFLogxK

U2 - 10.1016/j.jacasi.2025.07.009

DO - 10.1016/j.jacasi.2025.07.009

M3 - Journal article

C2 - 40884522

SN - 2772-3747

VL - 5

SP - 1260

EP - 1269

JO - JACC. Asia

JF - JACC. Asia

IS - 10

ER -

Transjugular Transcatheter Tricuspid Valve Replacement in Patients With Cardiac Implantable Electronic Devices

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