Tricuspid leaflet flail after Micra™ leadless pacemaker implantation: a case report

Annachiara Pingitore; Simone Calcagno; Loris Salvador; Silvia Mennuni; Elena Cavarretta

doi:10.1093/ehjcr/ytac154

Tricuspid leaflet flail after Micra™ leadless pacemaker implantation: a case report

Eur Heart J Case Rep. 2022 Apr 15;6(6):ytac154. doi: 10.1093/ehjcr/ytac154. eCollection 2022 Jun.

Authors

Annachiara Pingitore¹, Simone Calcagno¹, Loris Salvador², Silvia Mennuni¹, Elena Cavarretta³

Affiliations

¹ Department of Cardiology, San Paolo Hospital, Civitavecchia, Italy.
² Department of Cardiac Surgery, San Bortolo-AULSS 8 Berica, Vicenza, Italy.
³ Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Abstract

Background: Currently, the leadless pacemaker indications are limited to few and highly selected cases.

Case summary: We describe the first reported case of an atrioventricular Micra™ leadless pacemaker implantation complicated by tricuspid posterior leaflet flail with severe regurgitation in a 29-year-old man affected by asymptomatic and progressive high degree atrio-ventricular block. The patient was then treated with endoscopic tricuspid valve repair, leadless pacemaker removal and implantation of an epicardial pacemaker.

Discussion: Leadless pacemaker complications are multiple, hence it is essential to ensure a safe procedure, especially in the younger patients. We thought that the application of a transesophageal echocardiography guidance might mitigate the risk of major complications.

Keywords: Atrio-ventricular block; Echocardiography; Endoscopic cardiac surgery; Leadless pacemaker; Micra device; Tricuspid leaflet flail.

Publication types

Case Reports