Abstract：
Orthotopic transcatheter tricuspid valve replacement (TTVR) devices have been shown to be highly effective in reducing tricuspid regurgitation (TR), and interest in this therapy is growing with the recent commercial approval of the first orthotopic TTVR. Recent TTVR studies report preexisting cardiac implantable electronic device (CIED) transvalvular leads in ∼35% of patients, with entrapment during valve implantation. Concerns have been raised regarding the safety of entrapping leads and counterbalanced against the risks of transvenous lead extraction (TLE) when indicated. This Heart Valve Collaboratory consensus document attempts to define the patient population with CIED lead-associated or lead-induced TR, describe the risks of lead entrapment during TTVR, delineate the risks and benefits of TLE in this setting, and develop a management algorithm for patients considered for TTVR. An electrophysiologist experienced in CIED management should be part of the multidisciplinary heart team and involved in shared decision making.
摘要：
原位经导管三尖瓣置换术（TTVR）装置已被证明在减少三尖瓣反流（TR）方面非常有效，随着最近第一个原位TTVR的商业批准，对这种疗法的兴趣正在增长。最近的TTVR研究报告，约35%的患者预先存在心脏植入式电子设备(CIED)经瓣导线，在瓣膜植入过程中截留。引起了人们对截留导线的安全性的关注，并在指示时抵消了经静脉导线提取（TLE）的风险。心脏瓣膜联合实验室共识文件试图定义CIED导线相关或导线诱导TR的患者群体，描述TTVR期间铅截留的风险，在此设置中描述TLE的风险和收益，并为考虑进行TTVR的患者开发管理算法。在CIED管理方面经验丰富的电生理学家应该是多学科心脏团队的一部分，并参与共同决策。
