Surgical Repair After Leadless Pacemaker-Induced Avulsion of Tricuspid Valve

The use of the leadless pacemaker system (Micra; Medtronic) has grown in popularity with a lower risk of postimplantation complications associated with traditional pacemakers. We describe the case of a 78-year-old woman who presented with torrential tricuspid regurgitation due to avulsion of the anterior papillary muscle and entire chordal apparatus of the tricuspid valve after Micra pacemaker placement at an outside hospital. After she was deemed ineligible for transcatheter approaches, she underwent a minimally invasive tricuspid valve operation. Although her planned operation was valve replacement, she underwent a successful repair with postoperative echocardiography demonstrating no residual torrential tricuspid regurgitation.