Severe Tricuspid Stenosis Secondary to Permanent Pacemaker Lead
Asif Khan1, Ahmad Mustafa1, Joanne Ling1
1Department of Medicine, Staten Island University Hospital, Staten Island, NY 10305, USA.
Journal of Medical Cases
|September 21, 2022
Summary
Tricuspid stenosis (TS) from pacemaker leads can recur, even after balloon valvuloplasty. Tricuspid valve replacement may be a durable solution for this rare condition.
Area of Science:
- Cardiology
- Cardiac Surgery
- Valvular Heart Disease
Background:
- Tricuspid stenosis (TS) is a rare valvular heart disease, often linked to rheumatic heart disease or, increasingly, permanent pacemaker leads.
- Management of TS secondary to pacemaker leads is challenging due to limited long-term outcome data.
Observation:
- A case of a female patient with TS secondary to permanent pacemaker leads, managed pre-conception, is presented.
- Initial balloon valvuloplasty for moderate to severe TS was successful, allowing a healthy pregnancy and delivery.
- Recurrent severe TS was noted before a second pregnancy, suggesting potential lead-induced restenosis.
Findings:
- Repeat balloon valvuloplasty was unsuccessful.
- The patient underwent successful tricuspid valve replacement, with no signs of restenosis years later.
- This case highlights the potential for early restenosis after valvuloplasty in pacemaker lead-associated TS.
Implications:
- Tricuspid valve replacement appears to be a viable and potentially durable option for managing severe pacemaker lead-associated TS.
- Further research is needed to establish long-term outcomes for various management strategies of TS secondary to permanent pacemaker leads.
- This case underscores the importance of vigilant monitoring for restenosis in patients with TS related to permanent pacemaker leads.
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