A 75-year-old man was admitted under Dr.Hamdulay with a history of Rheumatic Heart Disease with Mitral Valve Stenosis with PAF Since 1999 was on Antiarrthymic drug with Antiplatelet and Anticoagulant. In 2005 he underwent Mitral Valve Replacement by Dr.Hamdulay. In July 2019 he had palpitation with PAF and was admitted at Jupiter hospital and treated with Antiarrythymic drugs with Anticoagulant drug. During the stay in Jupiter he developed a Tachy-Brady Arrthymia followed by which PPI done.

Medical History
A 75-year-old male was admitted under Dr. Hamdulay with a history of Rheumatic Heart Disease with Mitral Valve Stenosis with PAF Since 1999 was on Antiarrthymic drug with Antiplatelet and Anticoagulant. In 2005 he underwent Mitral Valve Replacement by Dr.Hamdulay. In July 2019 he had palpitation with PAF and was admitted at Jupiter hospital and treated with Antiarrythymic drugs with Anticoagulant drug. During the stay in Jupiter he developed a Tachy-Brady Arrthymia followed by which PPI done.

Medical History
Known case of Rheumatic Heart disease with Mitral Valve Stenosis with PAF since 1999.

Post MVR 2005

PPI in July 2019

Hypothyroid since 2015

2D Echo Report

Pre TMVR

Peak by mean gradient across prosthetic mitral valve from 15/6mm of hg to 19/7mm of hg
Dilated LA/RA
Grade 1/4 AR
Pasp by tr jet 43 mm of hg
Mitral valve diameter varies from 39.8 mm and 43.7 mm
LVEF 50%

Post TMVR

Well functioning bioprosthetic valve in mitral position no turbulence and laminar flow noted
Mitral peak by mean gradient pht = 9/2 mm of hg
Mitral valve area = 2.0 sqcm
Mildly sclerotic aortic valve with peak gradient 20 systolic
Psp by tr jet 35 mm of hg
LVEF 50-55%
Management/Progress in Hospital

Post procedure shifted to ICCU for Cardiac Monitoring. ICCU stay was uneventful with no fresh complaint hence shifted to ward and discharged with stable hemodynamic