Severe tricuspid valve stenosis secondary to pacemaker leads presenting as ascites and liver dysfunction: A complex problem requiring a multidisciplinary therapeutic approach

Document Type

Journal Article

Publication Date

1-1-2009

Journal

Journal of Interventional Cardiac Electrophysiology

Volume

24

Issue

1

DOI

10.1007/s10840-008-9309-z

Keywords

Ascites; AV block; Liver dysfunction; Pacemaker; Pacing leads; Superior vena cave stenosis; Tetralogy of Fallot; Tricuspid valve stenosis

Abstract

Tricuspid stenosis secondary to ventricular pacemaker leads is uncommon. We present a unique case of iatrogenic tricuspid stenosis secondary to fusion of the valve leaflets to transvenous implanted pacing leads. This occurred in an adult with childhood repaired Tetralogy of Fallot and high grade surgical heart block following multiple pacemaker procedures. The case was complicated by superior vena cava (SVC) and innominate vein stenosis secondary to implanted pacing leads, severe tricuspid valve (TV) stenosis, perforation of the heart by one of the implanted transvenous ventricular pacing leads, prolapse of the transvenous atrial pacing lead into the right ventricle, and unusual coronary sinus anatomy. We describe a multidisciplinary approach to management. © Springer Science+Business Media, LLC 2008.

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