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.