Iskandar Said B, Ann Jackson S, Fahrig Stephen, Mechleb Bassam K, Garcia Israel D
Department of Cardiology, East Tennessee State University, James H. Quillen College of Medicine, Johnson City, TN 37604, USA.
Echocardiography. 2006 Sep;23(8):692-7. doi: 10.1111/j.1540-8175.2006.00289.x.
Pacemaker implantation can be associated with several complications, including myocardial perforation with or without pericardial effusion, venous thrombosis, vegetations of the tricuspid valve (TV) or pacing lead, and tricuspid regurgitation (TR). The TR is thought to be derived from deformity or perforation of the TV by the pacing lead or secondary to atrioventricular discordance with asynchronous ventricular pacing. Severe TR can be deleterious to the patient because it raises the central venous pressure by increasing the right sided preload. Chronically, the increase in right sided blood volume can result in an increase in the right atrial pressure leading to a decrease in venous return and low cardiac output. Severe TR from leaflet adhesion to the pacemaker lead has not been reported before. With the aging of the population and the expanding use of pacemakers and implantable cardioverter defibrillators (ICD) in clinical practice, this complication may be seen more frequently. We present a patient diagnosed with severe TR, years after his pacemaker implantation. His TR was thought to be caused by adhesion of the tricuspid valve to his pacemaker lead.
起搏器植入可能会引发多种并发症，包括伴有或不伴有心包积液的心肌穿孔、静脉血栓形成、三尖瓣（TV）或起搏导线赘生物以及三尖瓣反流（TR）。TR被认为是由起搏导线导致的TV畸形或穿孔，或继发于房室不同步与心室非同步起搏。严重的TR对患者可能有害，因为它会通过增加右侧前负荷来升高中心静脉压。长期来看，右侧血容量增加会导致右心房压力升高，进而导致静脉回流减少和心输出量降低。此前尚未有因瓣叶粘连至起搏器导线导致严重TR的报道。随着人口老龄化以及起搏器和植入式心脏复律除颤器（ICD）在临床实践中的使用不断增加，这种并发症可能会更频繁地出现。我们报告了一名在起搏器植入多年后被诊断为严重TR的患者。他的TR被认为是由三尖瓣与起搏器导线粘连所致。
