Massive Tricuspid Regurgitation After Implantable Cardioverter Defibrillator Lead Extraction: A Late Complication From Ghost Material [case report].
Options
BORIS DOI
Publisher DOI
PubMed ID
41173609
Description
Background
Moderate tricuspid regurgitation (TR) is seen as pathological and can result from atrial or ventricular dilatation or interaction with device leads. Rarely, fibrotic remnants after transvenous lead extraction (TLE), referred to as "ghost material", can impair tricuspid valve function.
Case Summary
A 64-year-old woman presented with dyspnea and fatigue. Echocardiography revealed massive primary TR, with a flail-like appearance of the posterior leaflet caused by a linear mobile structure retracting the leaflet. During surgery, the structure was identified as remnant fibrotic material of previous TLE, causing progressive massive TR in the course of 20 years.
Discussion
After TLE, residual fibrotic remnants, referred to as "ghost material", when attached to the valve apparatus can lead to progressive TR, even after many years.
Take-home Message
Long-term outpatient follow-up is essential after TLE, as TR may progress and "ghost material" may even further induce fibrosis on the valve apparatus.
Moderate tricuspid regurgitation (TR) is seen as pathological and can result from atrial or ventricular dilatation or interaction with device leads. Rarely, fibrotic remnants after transvenous lead extraction (TLE), referred to as "ghost material", can impair tricuspid valve function.
Case Summary
A 64-year-old woman presented with dyspnea and fatigue. Echocardiography revealed massive primary TR, with a flail-like appearance of the posterior leaflet caused by a linear mobile structure retracting the leaflet. During surgery, the structure was identified as remnant fibrotic material of previous TLE, causing progressive massive TR in the course of 20 years.
Discussion
After TLE, residual fibrotic remnants, referred to as "ghost material", when attached to the valve apparatus can lead to progressive TR, even after many years.
Take-home Message
Long-term outpatient follow-up is essential after TLE, as TR may progress and "ghost material" may even further induce fibrosis on the valve apparatus.
Date of Publication
2025-10-29
Publication Type
Article
Keyword(s)
transthoracic and transesophageal echocardiography
•
transvenous lead extraction
•
tricuspid regurgitation
•
tricuspid valve
Language(s)
en
Contributor(s)
Series
JACC: Case Reports
Publisher
Elsevier
ISSN
2666-0849
Related Collection(s)
Access(Rights)
open.access