After a recent mitral valve repair, a patient arrived in the Cath lab holding area for postoperative observation. During the assessment, Caroline, a diligent nurse, noticed the absence of distal pulses through both palpation and Doppler, raising immediate concern. She quickly alerted the interventionalist and fellow team members, prompting a swift response from the team. Upon evaluation, the team attempted to restore the pulse by deflating the FEM stop, a pressure device applied to the access pulse procedure, but the pulses remained absent. An urgent vascular consult was requested, and the response was immediate. The vascular team recommended an ultrasound and a STAT CT scan, which revealed a blockage in the affected leg.

Emergency surgery was promptly initiated, and the absence of pulses was attributed to a malfunction in the closure device at the access site. The surgery was successful, and the patient's pulses were fully restored, leading to a complete recovery. This case highlights the critical importance of vigilant post-procedure monitoring and the value of teamwork and emergency management in the Cath lab. The nurses' quick identification and escalation, combined with the coordinated efforts of the interventional, vascular, and surgical teams, were essential to ensure the patient's successful outcome. Caroline takes her time with every patient assessment, asks questions, and is dedicated to maintaining excellent patient outcomes. We want to acknowledge her invaluable dedication to her patients.