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It was reported that on (b)(6) 2026, a 19mm epic plus supra valve was chosen for a procedure.The valve was implanted as per the standard surgical protocol.Following weaning from cardiopulmonary bypass (cpb), intraoperative transesophageal echocardiogram tee demonstrated persistently high transvalvular gradients across the prosthesis (ppg/mpg: 70/46 mmhg).After a thorough evaluation, no technical, anatomical, or surgical cause, including left ventricular outflow tract obstruction (lvoto), was identified.The patient was placed back on cpb, the valve was explanted, and a non-abbott mechanical valve was implanted.Repeat tee showed satisfactory valve function with acceptable gradients (ppg/mpg: 30/17 mmhg).The patient was subsequently weaned off cpb successfully, and the remainder of the procedure was uneventful.The patient was shifted to the intensive care unit (icu) with stable hemodynamics.There was no delay in the procedure.The patient was reported discharged.
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