unilateral neck veins after CRD,Mitral valve cliping

[yasso313]

58 years old male with long term cardiac trouble old MI,high amaylase,lipase suggesting drug induced pancreatitis with high blood sugar now normal lipase high amaylase,controlled blood sugar  with insulin,stent done 3 years ago,mitral valve regurgitation,low ejection fraction had mitral valve clipping,CRD ,ejection fraction raised nearly double,cardiac muscle contraction improved,no more dyspnea still directly after operation had fever,attacks,suspected pulmonary embolism due to bilateral lower limbs edema too he also had high liver enzymes,took anticoagulants and recovered with great echo results,free chest  x-ray,enzymes and kidney functions returned normal nearly 10 days post operative,yet being still on marevan,plavix,viag,the unilateral neck veins still there with very mild unilateral lower limb edema same side left side,knowing that preoperative he had a cardiac catheteraization and during CRD they told him there's catheter like procedure,what could be possible diagnosis now knowing that less than 2 weeks ago echo was free with nearly 45 ejection fraction?

[CCFCardio MD2]

Look for tricuspid regurgitation.  If I understand your question correctly, it sounds as if the EF is 45% but he still has an elevated JVP and some lower extremity edema.  This could be explained by right heart failure or tricuspid regurgitation.  Maybe during his pacemaker implantation the tricuspid valve was damaged.  Or he could just be a little volume overloaded and will improve with some diuretic.  Hope this helps.

[yasso313]

thanks he believes it might be right heart failure due too increase volume overload valves r ok he just had echo we believe post operative he had pulmonary embolism that resolved with anticoagulants n might caused the right heart failure though no dyspnea anymore n bilateral ll edema was only there for 2 days that was like 5 weeks ago