1. Complex Tricuspid Valve Repair in Patients With Pacer Defibrillator–Related Tricuspid Regurgitation 
Jaishankar Raman, MMedBS, PhD, Lissa Sugeng, MD, MPH, David T.M. Lai, MD, FRACS, Valluvan Jeevanandam, MD 
The Annals of Thoracic Surgery 
Volume 101, Issue 4, Pages (April 2016)
DOI: /j.athoracsur
Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

2. Fig 1
Operative photograph of defibrillator lead traversing tricuspid valve impinging on and pushing down septal leaflet of tricuspid valve.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

3. Fig 2
Steps of repair: (1) Mobilized defibrillator lead and leaflets of tricuspid valve, (2) lead repositioned in cleft between septal and inferior/posterior leaflets with suture approximation of leaflets above cleft, and (3) repositioned lead with cleft closure and tricuspid valve annuloplasty.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur )
Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions