Abstract
In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead. While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy. The development of specialized leads have made lead implantation via coronary sinus (CS) an attractive alternative for pacing in this patient population.
Highlights
In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead
While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy
Discuss management approach for pacing in patients with mechanical tricuspid valve and important considerations indecision making. This case is of a 66-year-old female with a history of mechanical aortic, mitral, and tricuspid valve replacements in Spain in 1977 for endocarditis reportedly caused by a dental infection
Summary
In patients with mechanical tricuspid valve replacement (TVR), management of atrioventricular conduction abnormalities can be challenging given inaccessibility of the right ventricle (RV) with an endocardial pacing lead. While implantation of an epicardial lead may serve as an alternative; it requires invasive surgical placement and is not an ideal option in patients with prior thoracotomy. The development of specialized leads have made lead implantation via coronary sinus (CS) an attractive alternative for pacing in this patient population
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