Pacemaker Lead Entrapment Complicating Heterotopic Transcatheter Tricuspid Valve Implantation

Abstract

A 75-year-old woman presented with progressive dyspnea and peripheral edema. Her history included atrial fibrillation, mechanical mitral prosthesis, dual-chamber pacemaker, and chronic kidney disease. Echocardiography revealed severe functional tricuspid regurgitation, originating from the posteroseptal commissure, with mild right ventricular dysfunction (Fig. 1A). After heart team review, the patient was deemed inoperable and unsuitable for transcatheter edge-to-edge repair or annuloplasty because of anticipated mechanical interference of the pacemaker lead.