ACUTE PAILLARY MUSCLE RUPTURE WITH SEVERE MR

ACUTE PAILLARY MUSCLE RUPTURE WITH SEVERE MR72-year-old female presented with chest discomfort for which ECG was taken which revealed inferior wall myocardial infarction. She underwent emergency coronary angiogram which revealed 100% occlusion of right coronary artery. Since the right coronary artery was ectatic and torturus, balloon dilatation along with intracoronary thrombolysis. She was observed in ICU and was shifted to ward after 3 days of procedure. After one week patient had recurrent ventricular arrhythmia and pulmonary edema. She was shifted back to ICU and got intubated. Her ABG showed severe metabolic acidosis and echo revealed severe mitral regurgitation, chordae rupture,

DOUBLE VALVE REPLACEMENT

||DOUBLE VALVE REPLACEMENT||51 years old female presented with complaints of breathlessness (NYHA class III). Her echocardiogram revealed severe mitral stenosis with mild to moderate aortic regurgitation, mild LV systolic dysfunction (LVEF -45%). Her coronary angiogram was normal. She was posted for mitral valve replacement by Dr. Srinath Vijayasekharan & Dr. Senthil Kumar and Team. Intraoperatively her TEE showed moderate to severe aortic regurgitation. Consent for double valve replacement was taken during procedure and both mitral and aortic valve was replaced with TTK Chitra valve under cardiopulmonary bypass. Post operatively she remained hemodynamically stable and discharged without any complications.

ACUTE STROKE LEADING TO MVR

||ACUTE STROKE LEADING TO MVR|| 53 years old female is a known case of mitral restenosis presented with complaints of breathlessness. On evaluation found to have moderate mitral restenosis. She was advised to be on regular follow up but after two weeks, she presented with weakness of lower limb and giddiness for which emergency MRI brain was done which revealed acute lacunar infarct in the right frontal lobe. In view of acute stroke probably due to cardioembolic origin, patient posted for mitral valve replacement and the surgery was performed by Dr. Srinath Vijayasekharan & Dr. Senthil Kumar & Team. Intraoperatively

CABG IN LIVER FAILURE

||CABG IN LIVER FAILURE|| 55 years old gentleman know case of autoimmune hepatitis, old CVA, CKD. He presented with ongoing chest pain with recurrent episodes of rest angina with coronary angiogram revealed severe triple vessel disease. Due to chronic liver failure, patient had ascites and pulmonary hypertension. He was posted for high risk CABG under Dr. Srinath Vijayasekharan, Dr. Senthil kumar and Team.  Intraoperatively he had difficult intubation and also high airway pressure with supra systemic pulmonary artery pressure. TEE revealed moderate to severe mitral regurgitation but it was dynamic suggesting ischemic origin of MR hence it was decided to

CABG AFTER LIVER TRANSPLANT

CABG AFTER LIVER TRANSPLANT 64 years old gentleman underwent PTCA in May 2023. He had chronic liver disease for which he underwent liver transplantation in January 2024. Now he presented with complaints of chest pain and breathlessness on exertion. Coronary angiogram revealed triple vessel disease. He was posted for elective CABG under Dr. Srinath Vijayasekharan, Dr. Senthil Kumar and Team. Intraoperatively he had moderate PAH but tolerated off pump CABG without any hemodynamic issues. Post operatively he remained hemodynamically stable and discharged without any major complications.

PARAVALVULAR LEAK REPAIR

PARAVALVULAR LEAK REPAIR 64 years old female underwent CABG with MVR one year back in an outside hospital but she had multiple hospital admission for the past one year for recurrent pulmonary edema. On evaluation she was found to have grade II paravalvular leak with moderate PAH and RV dysfunction. She was posted for high-risk redo mitral valve replacement or repair of paravalvular leak by Dr. Srinath Vijayasekharan, Dr. Senthil Kumar and Team. Intraoperatively we were able to close the paravalvular leak without any major complications. Post operatively she remained hemodynamically stable and discharged without any major complications.