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Transcatheter Extraction and Implantation of a Novel Leadless Pacemaker via Tricuspid Valve-in-Valve: A Case Report
Zijia Wu1, Shuyi Zeng1, Zhihai Lin1
1Department of Cardiology, Yulin First People's Hospital, The Sixth Affiliated Hospital of Guangxi Medical University, Yulin, China.
Background:
Transcatheter retrieval of a dislodged leadless pacemaker (LP) from a tricuspid valve-in-valve (ViV) prosthesis has not been previously reported.
Case Summary:
A 42-year-old woman with a prior bioprosthetic tricuspid valve, transvenous pacemaker, and subsequent percutaneous ViV implantation presented with ventricular lead dysfunction. A Micra LP was implanted but dislodged within 7 days. The device was retrieved using a sheath-in-sheath system combined with a double-snare technique under fluoroscopic guidance. The first snare engaged the device, and traction induced tine deformation and device mobilization. After retraction into the right atrium, a second snare enabled coaxial alignment for safe retrieval into the introducer sheath. A new LP was immediately reimplanted with stable electrical parameters that remained satisfactory at 1-year follow-up. No prosthetic valve injury or thromboembolic complications occurred.
Conclusion:
This case demonstrates that transcatheter retrieval and same-day reimplantation of LP via a tricuspid ViV prosthesis is feasible and safe.
