Patient Information:
A 40-year-old female presented with shortness of breath (New York Heart Association class III), orthopnoea and bilateral lower limb oedema for one year. Her symptoms affected her quality of life (American Association of Anesthesia class IV). She was diagnosed with severe MV regurgitation, pulmonary hypertension, and secondary severe tricuspid valve (TV) regurgitation with normal left and right ventricular function. She is hypertensive and suffers from chronic atrial fibrillation. She takes warfarin.