Transvenous valve‐in‐valve replacement preserving the function of a transvalvular defibrillator lead

Although feasibility and efficacy of percutaneous tricuspid valve‐in‐valve implantation have been established, a transtricuspid pacing or defibrillator lead might preclude this technique: lead damage can cause lead dysfunction resulting in inappropriate or inefficient pacing or shocks. In these cases, lead removal is thought to be the only option. We describe a patient who presented with rapid clinical deterioration due to tricuspid valve stenosis early after implantation of an internal defibrillator with a transvalvular shock‐lead. A transvenous valve‐in‐valve implantation of the tricuspid valve was performed after protecting the defibrillator‐lead with a custom‐made covered stent. We describe the technical issues, the clinical outcome, and the evolution of lead function after implantation. © 2014 Wiley Periodicals, Inc.