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Journal of Medical Ultrasonics

, Volume 41, Issue 1, pp 69–71 | Cite as

Massive tricuspid regurgitation due to pacemaker-lead puncture of the tricuspid valve: successful diagnosis by 3-dimensional echocardiography

  • Rina Tamai
  • Tomoya Hara
  • Hirotsugu YamadaEmail author
  • Susumu Nishio
  • Mika Bando
  • Junko Hotchi
  • Shuji Hayashi
  • Toshiyuki Niki
  • Tetsuya Kitagawa
  • Masataka Sata
Case Report

Abstract

An 83-year-old woman presented to our echocardiographic center with symptoms of right heart failure. A dual-chamber DDDR pacemaker had been implanted 9 years earlier. Two-dimensional echocardiography revealed right atrial and ventricular enlargement and massive tricuspid regurgitation with immobilization of the anterior leaflet of the tricuspid valve. Three-dimensional transesophageal echocardiography showed that the pacemaker lead had punctured the leaflet. These echocardiographic findings were confirmed during surgery. The pacemaker lead was transected and removed, and pericardial patch closure of the leaflet hole and tricuspid annuloplasty were performed. The mechanism of regurgitation was elucidated by real-time three-dimensional echocardiography, and surgical repair was straightforward.

Keywords

Pacemaker-lead puncture Tricuspid regurgitation 3-Dimensional echocardiography 

Notes

Conflict of interest

None.

Supplementary material

Supplementary material 1 (WMV 2784 kb)

10396_2013_459_MOESM2_ESM.wmv (279 kb)
Supplementary material 2 (WMV 278 kb)

References

  1. 1.
    Lin G, Nishimura RA, Connolly HM, et al. Severe symptomatic tricuspid valve regurgitation due to permanent pacemaker or implantable cardioverter-defibrillator leads. J Am Coll Cardiol. 2005;45:1672–5.PubMedCrossRefGoogle Scholar
  2. 2.
    Seo Y, Ishizu T, Nakajima H, et al. Clinical utility of 3-dimensional ehocardiography in the evaluation of tricuspid regurgitation caused by pacemaker leads. Circ J. 2008;72:1465–70.PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Society of Ultrasonics in Medicine 2013

Authors and Affiliations

  • Rina Tamai
    • 1
  • Tomoya Hara
    • 1
  • Hirotsugu Yamada
    • 1
    • 2
    Email author
  • Susumu Nishio
    • 2
  • Mika Bando
    • 1
  • Junko Hotchi
    • 1
  • Shuji Hayashi
    • 2
  • Toshiyuki Niki
    • 1
  • Tetsuya Kitagawa
    • 3
  • Masataka Sata
    • 1
    • 2
  1. 1.Department of Cardiovascular MedicineTokushima University HospitalTokushimaJapan
  2. 2.Ultrasound Examination CenterTokushima University HospitalTokushimaJapan
  3. 3.Department of Cardiovascular SurgeryTokushima University HospitalTokushimaJapan

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