Post Closed Mitral Valvotomy, post Double valve replacements, and a percutaneous tricuspid valve , well, there are adhesions and adhesions and that can provide a tumbling block to reach the heart. But since the patient was in Complete Heart Block, we had to find an access . We went through a small sub- xiphoid incision and gave her an epicardial pacing lead and the pacemaker .
She is a frail lady. Extremely sick till y'day. And has suddenly seen a sea change in her condition today. Guess, there is a way for everything. And yes, we were lucky too...!
August 2023
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