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.

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