Retained Pacemaker Lead Fragment-Induced Fibrosis, Resulting in Impaired Tricuspid Valve Function, Managed with a Valve-Sparing Open Surgical Approach

Abstract

Kevin M Lichtenstein, Thomas B Russell and Jamil G Bashir

Retained pacemaker lead fragments can induce fibrosis which can affect valve function. In this case, a female patient in her fifties had undergone pacemaker insertion in her teens for symptomatic bradycardia. Due to pacemaker pocket erosion, she had undergone a lead extraction where lead fragments were left in-situ. Over time, she gradually developed symptomatic tricuspid dysfunction. Due to the severe impact on her quality of life, the patient opted for an open surgical approach. Intraoperatively, electrocautery was used to debride the fibrotic tissue inhibiting the leaflets of the tricuspid valve. This resulted in marked improvement of valve function and additional repair/replacement was not necessary. To our knowledge, such a case has not been previously described.

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