Luminal vena cava superior and right atrial obstruction associated with severe tricuspid valve stenosis due to endocardial pacemaker leads: an extremely rare complication of permanent pacemakers

In this report, we describe a case with severe tricuspid stenosis associated with partial luminal obstruction of the right atrium and vena cava superior secondary to transvenous pacemaker leads in a 49-year-old patient who had a permanent pacemaker implanted 17 years ago. The patient had no specific symptoms related to above findings; however, after clinical suspicion, transthoracic and transoesophageal echocardiographic examination showed large mobile masses attached to the thickened transvenous pacemaker leads. Leads and generator were removed surgically, but some parts of transvenous leads could not be extracted due to massive fibrotic adhesions. It is possible that such cases will be more common due to increasing number of cardiac rhythm device implantations.