One of the dreaded mechanical complications of mitral valve replacement (MVR) is rupture of the left ventricle (LV). This report describes the early diagnosis and successful repair of rupture of posterior wall of LV in an elderly patient who underwent MVR. We have discussed the risk factors and perioperative issues implicated in such complication. The anesthesiologist as an intra-operative echocardiographer can aid in identifying the patient at risk. Though important surgical steps are necessary to prevent the complication; nonetheless, the anesthesiologist needs to take key measures in the perioperative period.

Fish bone as foreign body in throat is very common in otorhinolaryngology practice. But a live fish in oropharynx is very rare. Small fishes, if ingested, can cross the oral cavity and migrate to esophagus, nasopharynx, or airway, but large fishes get impacted in the oropharynx. Most of these cases are life-threatening and require immediate intervention to save the patient.Sometimes, tracheostomy is required to establish the airway and to remove the fish. We are reporting a case of live climbing perch (Anabas testudineus) which was successfully removed from the oropharynx of a 30-year-old male without tracheostomy. We will mainly discuss the proper technique to remove live foreign bodies without causing any complications.

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