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BACKGROUND Implantation of prosthetic cardiac valves to treat haemodynamically significant valvular diseases has become common; however, it is associated with complications. Thus, this study was intended to evaluate the indications for implantation of prosthetic valve and complications after its implantation and prognosis after treatment of one of its complication, i.e. stuck valve. MATERIALS AND METHODS This was a single-centered study wherein 50 patients who came to the emergency department with stuck valve were assessed. The 2D echocardiography was performed in all patients. Thrombolysis was done and the gradients were reassessed. Further response to treatment and development of complications before and after treatment were observed. RESULTS Of total patients, 60% were females. Mean age group was 30-40 yrs. Most of them were asymptomatic for 6 years and there was lack of compliance in 90% of patients. Most common indication for valve replacement was mitral stenosis (60%) followed by mitral regurgitation (20%), aortic regurgitation and aortic stenosis (10%) and combined mitral and tricuspid regurgitation (10%). Commonest valve was St. Jude (90%). Pannus was observed in 10% patients and thrombus was observed in 50% patients. Most patients had gradients 45/20 mmHg across mitral valve. In about 90% patients, gradients decreased after thrombolysis (12/5 mmHg). The complications after thrombolysis were hemiparesis (4%), death before thrombolysis (6%) and death after thrombolysis (4%). CONCLUSION Considering these results, it can be concluded that prosthetic valves are seldom associated with some complications. Further, thrombolysis can be effective in patients with prosthetic valve thrombosis.

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BACKGROUNDThe angiographic findings and prognosis of patients with Complete Heart Block (CHB) remain unclear. Thus, we aimed to study the clinical profile, risk factors, angiographic distribution and in-hospital outcomes of patients with complete heart block. MATERIALS AND METHODSThis was a prospective, single-centred study which included 100 patients who came to the emergency department with CHB. Routine blood investigations including serum electrolytes were done. Coronary angiogram was done and lesions were assessed. Temporary pacemaker was implanted followed by permanent pacemakers in required patients, and in-hospital complications were noted down. RESULTSCommonest age group was above 60 years (75%). The patients were predominantly males. Most common presentation was chest pain (60%); there was regional wall motion abnormality in 30% patients. Degenerative complete heart block was seen in 34% patients, diphtheric myocarditis in 15%, hypokalaemic in 15%, dilated cardiomyopathy in 2%. Of total 53 patients had AV block, 14 had bifascicular block, 23 had LBBB, 6 had RBBB, 3 had Mobitz I and 1 had Mobitz II. Inferior wall myocardial infarction (MI) was pervasively present in patients. Temporary pacemakers were implanted in 6 patients and permanent pacemakers in 43 patients. In-hospital outcomes constituted of complication like cardiogenic shock (10%) and death (26%). The patients who died either had 80% -90% stenosis in RCA, triple vessel disease, ostioproximal LAD occlusion or diphtheric myocarditis. CONCLUSIONComplete heart block was majorly associated with advanced age and inferior wall MI, virtually caused by dominant RCA occlusion. The in-hospital mortality was significantly higher in the patients with CHB.