We describe a patient in whom permanent endocardial pacing was accomplished by passage of the electrode through a porcine bioprosthetic tricuspid valve, thereby obviating the need for a second thoracotomy. After 8 years of follow-up, the patient continues to do well with satisfactory pacing and bioprosthetic valve function at the first change of pulse generator.

A patient accidentally drove a darning needle through her chest wall into her left ventricle. After referral five weeks later as possible case of infective endocarditis, the needle was detected and removed successfully by open heart surgery. It was localised precisely by echocardiography.

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