A 61 y.o. male S/P mitral ring annuloplasty and S/P AID-CTR was admitted for HTx. ECHO shows mod AoS, and severe MR, and CATH readings are: PCP 23 mmHg, transpulm grad 12 mmHg, PVR 2,8 WU, card index 2,57 l.m.m2. Angio MRI shows hepatic & splenic inversion with abscence of IVC and persistent LSVC. Right renal and inferior body veins drain via azygos, while left renal and hepatic form a common collector in the RA . Thoughts on surgical strategy for HTx?

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