Ribeiro Hélder, Magalhães Pedro, Ferreira Catarina, Baptista Ana, Margato Renato, Carvalho Sofia, Rosa Policarpo, Mateus Pedro, Ferreira Alberto, Moreira J Ilídio
Serviço de Cardiologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, Unidade de Vila Real, Vila Real, Portugal.
Rev Port Cardiol. 2012 Apr;31(4):305-8. doi: 10.1016/j.repc.2012.02.008. Epub 2012 Mar 20.
Tricuspid stenosis (TS) is an uncommon complication of transvenous ventricular pacemaker implantation, with few cases reported in the literature. The mechanisms described are obstruction of right ventricular inflow by tricuspid vegetations (endocarditis), multiple pacemaker leads and tricuspid valve (TV) fibrosis secondary to perforation or laceration of the TV leaflets, or adherence between redundant portions of the lead and valvular and subvalvular tissue. We report two cases of severe TS, with different etiologies and management: one caused by leaflet perforation, resolved surgically, and the other secondary to fusion between a loop of the pacemaker lead and the subvalvular apparatus, which was treated medically.
三尖瓣狭窄(TS)是经静脉心室起搏器植入术的一种罕见并发症,文献报道的病例很少。所描述的机制包括三尖瓣赘生物(心内膜炎)、多条起搏器导线和三尖瓣(TV)纤维化导致右心室流入道梗阻,后者继发于TV瓣叶穿孔或撕裂,或导线多余部分与瓣膜及瓣膜下组织之间的粘连。我们报告两例严重TS病例,病因和处理方法不同:一例由瓣叶穿孔引起,通过手术解决;另一例继发于起搏器导线袢与瓣膜下装置融合,采用药物治疗。