C D
Figure 4: Transthoracic echocardiography. A- D
Intra-aortic balloon pump was secured for further stabilization and multi-
disciplinary team consensus was for urgent mitral valve intervention.
He was subsequently taken to operation theater on full personal protective
equipment (PPE). On surgical inspection mitral valve anatomy was unsuitable
for repair and hence decision was taken for emergent mitral valve
replacement. Intra-operative findings showed flail and unsupported anterior
mitral valve leaflet due to complete rupture of PMPM head. Mitral valve
replacement was performed using 31 mm magna ease bioprosthetic valve.
The patient was weaned off from IABP and then from inotropes. The
hemodynamics improved post operatively. He was further managed
medically.