Partial rupture of the tricuspid valve after extraction of permanent pacemaker leads: Detection by transesophageal echocardiography

Traumatic lesions of the tricuspid valve complicating pacemaker lead extrac tions appear to be rare. We report two cases of partial rupture of the tric uspid valve, following apparently uneventful extraction of permanent ventri cular leads, resulting in severe regurgitation and, in one case, chronic he art failure. TEE was useful to identify the traumatic mechanism of tricuspi d regurgitation (TR) and the extent of valvular lesions in these patients. Such etiology should be suspected, and TEE performed, in patients developin g TR or heart failure late after lead extraction.