Three-dimensional echocardiographic evaluation of severe tricuspid regurgitation due to leaflet damage by endocardial pacing lead

Abstract

A 76-year-old woman developed congestive heart failure within a year following permanent pacemaker implantation. She was found to have moderate to severe functional mitral regurgitation and severe tricuspid regurgitation. However, two-dimensional echocardiography was unable to delineate the impact of pacing lead on tricuspid regurgitation. Subsequent three-dimensional echocardiography visualized that the pacing lead had passed through the tricuspid septal leaflet causing severe regurgitation. This finding was confirmed during successful mitral and tricuspid repair.