Taira Kayano, Suzuki Asumi, Fujino Akihisa, Watanabe Tatsuya, Ogyu Atsuhiro, Ashikawa Kouichi
Department of Cardiovascular Medicine, Yonezawa City Hospital, Aioicho 6-36, Yonezawa, Yamagata 992-0085
J Cardiol. 2006 Jun;47(6):301-6.
Endocardial pacemaker leads may cause tricuspid valve regurgitation, but only four cases of tricuspid stenosis without endocarditis have been reported. A 77-year-old woman had received three endocardial leads when aged 44, 57, and 72 years. One lead pushed up the septal leaflet of the tricuspid valve from below the valve, then adhered to the leaflet, and was positioned against the ventricular septum. Tricuspid valve stenosis and moderate regurgitation were separately detected by transthoracic echocardiography. The tricuspid valve orifice area was 0.93 cm2 at cardiac catheterization. An excessive loop of a ventricular lead, especially a subvalvular loop, can cause opening limitation of the tricuspid valve, and the entangling of the lead in the subvalvular structures can easily induce reactive fibrosis and adhesions.
心内膜起搏器导线可能导致三尖瓣反流，但仅有4例无感染性心内膜炎的三尖瓣狭窄病例报道。一名77岁女性在44岁、57岁和72岁时分别植入了三根心内膜导线。一根导线从瓣膜下方向上推挤三尖瓣的隔叶，随后与该叶粘连，并紧贴室间隔。经胸超声心动图分别检测到三尖瓣狭窄和中度反流。心导管检查时三尖瓣口面积为0.93平方厘米。心室导线的过度袢曲，尤其是瓣膜下袢曲，可导致三尖瓣开放受限，且导线在瓣膜下结构中的缠绕容易诱发反应性纤维化和粘连。
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