Description
An 85-year-old female with history of hypertension, diabetes, coronary artery disease and emphysema presented with episodes of confusion. MRI demonstrated bilateral acute infarcts. She had non-ST elevation myocardial infarction and underwent percutaneous intervention with drug-elating stent for left anterior descending artery stenosis. Transthoracic echocardiography (TTE) (see online ) and transoesophageal echocardiography (TEE) demonstrated calcified left ventricular mass (LVM) (see online ), severe mitral annular calcification and moderate mitral stenosis (figure 1). Forced expiratory volume in one second 0.89 (85% of predicted), forced vital capacity 1.01 (69% of predicted) and frail body habitus. Multidisciplinary discussions (MDD) with family and they agreed to video-assisted LVM removal.1 2 Double lung ventilation was initiated, peripheral cardiopulmonary bypass (CPB) instituted through femoral vessels, ventilation stopped and resumed at the end of CPB. A 4 cm right intercostal incision performed and 10 mm videoscope inserted through separate 12 mm port. After cross-clamp, induction antegrade cardioplegia administrated...
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