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Elevated preprocedural CRP is not associated with increased risk for CI-AKI in patients undergoing PCI
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INTERESTING CASES

Case History :

23 year old man with a history of congenital heart disease since a long time. At 14 years of age he had patch closure of VSD, suture closure of ASD, placement of homograft conduit from pulmonary LV to main PA.But later at the age of 21 he had recurring atrial fibrillation with heart failure. Severe systemic tricuspid regurgitation was found. He was treated with sotalol, warferin, enalapril and digoxin.after this he resumed to his routine work full time and had only moderate exercise intolerance. He had restricted himself from foot ball and basket ball . He presents on this occasion with recurring atrial fibrillation. Medications: Amiodarone 200 mg daily, digoxin 0.125 mg daily, enalapril 30 mg daily, coumadin (target INR 2-3).

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Investigation Reports :

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Discussion :

A 23 year old man with congenitally corrected TGA, VSD, ADS, and PS. Had his original repair at age 16. Developed recurring atrial arrhythmias at age 21. Was found to have severe systemic tricuspid regurgitation and was treated medically. Progressive moderate exercise intolerance. Current admission precipitated by recurrent atrial fibrillation. His findings suggest mild stenosis of his conduit and significant systemic tricuspid regurgitation. Chronic atrial fibrillation is present. Investigations confirm severe systemic tricuspid regurgitation with moderate biventricular dysfunction. The conduit shows some calcification and stenosis. Surgical repair is elected.This patient should have gone to heart surgery three years earlier when he presented with atrial arrhythmias and severe left AV valve regurgitation. These patients should be operated on before their systemic ventricular function is compromised.

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