APC

       -Severe organic TR with moderate RV dysfunction (TAPSE 1.1cm)(No evidence of RVEMF, gigantic RA and hugely dilated IVC non collapsing). -Atrial fibrillation with controlled ventricular rate-Anemia-Hypochromic microcytic with iron deficiency, Blood loss due to haemoptysis and Haematemesis-Hypothyroidism-Chronic kidney disease- Stage 3 B (eGFR- 39 ml/min/1.73m²)Pallor, Raised JVP, hepatomegaly, Bilateral pedal edema, Irregularly irregular Pulse, Varing S1,  S2 Normal, Pansystolic Murmur
PRE 2.avi
PRE 3.avi

CMR.mp4

-TEE image was obtained with best visualisation of both SVC and IVC (Caval view)-Femoral vein Approach. -Pigtail Catheter in Right Pulmonary artery, as a marker for placement of SVC valve.-SVC Angio to delineate the anatomy(Innominate vien) for placement of SVC valve. -Terumo wire encircling the roof of RA for double check of the landing zone of the distal part of SVC valve. SVC valve was introduced after cut down of femoral vein and placed in SVC after all parameters of exact placement including venogram from right brachial vein SVC valve was released. -Hepatic Vein Angiogram for placement of IVC Valve where in the valve is placed just above the hepatic vein so as to prevent obstruction of hepatic flow. 
Pigtail catheter 1.mp4
SVC Angio 2.mp4
Terumo Wire 3.mp4
SVC Valve 4.mp4
SVC Valve 5.mp4
hepatic Valve Angio 6.mp4
IVC Valve 7 .mp4
Final 8.mp4
TEE 9.mp4

- Isolated tricuspid valve disease is a rear entity, usually occurs along with left sided valve disease. surgery for isolated right sided valve carries high morbidity and mortality