Pulmonary valve replacement
Previous cardiac surgery.
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Median sternotomy and pulmonary valve replacement.
Left nipple ring (fashion accessory).
The pulmonary valve is an uncommon form of prosthetic cardiac valves replacement.
Its location to the left of the midline close to the pulmonary trunk, allow for it identification.
Images courtesy of Dr Gregory Compton, Hospital for Sick Children in Toronto, Ontario, Canada.