Abstract
Only four cases of tricuspid stenosis related to endocardial pacemaker leads have been reported. Two further cases associated with perforation of a tricuspid valve leaflet by a pacemaker lead are presented: a 46 year old woman and a 60 year old man. It is possible that tricuspid valve disease related to endocardial pacemaker and non-thoracotomy defibrillator leads is underrecognised. Diagnosis requires clinical suspicion and the use of Doppler echocardiography. Recent evidence of fibrosis affecting the tricuspid valve in hearts from patients who have had non-thoracotomy defibrillator implants suggests that this problem could be more common in the future. Keywords: tricuspid stenosis; pacemaker leads
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Figure 1 .
Intraoperative photograph of the tricuspid valve in case 2. The atrial lead has been removed. The stenosed tricuspid valve is held open by two small retractors. The ventricular lead is seen perforating the septal leaflet of the valve.