Figure 6. A 3-D view of ventricular lead (arrow) crossing through mitral valve.
A sternotomy was performed for removal of the pacemaker leads. Despite extraction, mitral valve regurgitation was persistent (Figure 7). The mitral valve was thus repaired via closure of scallop via Alfieri stitch lead. In addition, the patent foramen ovale was closed. Patient also had CABGx1 with LIMA to LAD for an 80% stenosis of the mid LAD. Post-operative imaging showed successful extraction of leads and repair of the mitral valve (Figure 8).