Whilst tricuspid regurgitation (TR) secondary to severe mitral regurgitation (MR) is a common problem, organic TR caused by pacemaker leads is also frequently encountered. In a 63-year-old patient who developed TR attributable to both MR and a pacemaker lead inserted 12 years previously, the regurgitation could not be controlled satisfactorily using a normal ring annuloplasty. Consequently, the 'clover technique' provided an efficient correction to the TR.
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