Unusual complication of a retained pacemaker insulation sheath causing severe tricuspid regurgitation after heart transplantation

Purpose: Transthoracal and -esophageal echocardiography is a routinely used tool in functional examination of the heart especially after heart transplantation. It also can detect structural abnormalities which can hardly be seen in conventional x-ray and thoracic CT scan. Material and methods: After uneventfull heart transplantation with concomitant pacemaker explantation for dilative cardiomyopathy a 66 year old man developed four years later rapid progressive severe tricuspid regurgitation (TR). Several echocardiographic examinations done before at our institution showed no graft dysfunction, structural aabnor…