PMC10126593_01
EKG on admission showing ST depressions in leads V3-V5.
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Electrocardiogram showed sinus rhythm with ST depressions in leads V3-V5 (Figure 1).
Prominent cardiac silhouette status post median sternotomy.
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Chest X-ray did not show any acute cardiopulmonary process (Figure 2).
(a) Coronary angiography showed 80% occlusion of the vein graft to diagonal. (b)
Restoration of flow demonstrated after placement of DES.
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Thrombotic occlusion of the vein graft to diagonal was thought to be the culprit lesion with 80% occlusion (Figure 3(a)). There was improvement of flow and TIMI-3 flow was restored (Figure 3(b)).
(a) Color Doppler demonstrating severity of mitral regurgitation with (b) ECG tracing
of cardiac cycle.
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Transthoracic echocardiogram (TTE) revealed left ventricular ejection fraction (LVEF) 55% with evidence of left atrial enlargement and partially detached papillary muscle (Figure 4(a) and (b)).
TEE demonstrates the partially detached anterolateral papillary muscle head.
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Preoperative transesophageal echocardiogram (TEE) confirmed the PMR and postoperative TEE demonstrated no evidence of residual MR or decreased LVEF (Figure 5).