Our client was M. Jawad, MD a heart surgeon who was looking for medical illustrations to submit as part of a paper about tricuspid valve repair using autologous pericardium. Reference was sent in the form of a video of the actual heart surgery (fascinating to watch!) and a word document with photos and written description of the stages. Tricuspid valve endocarditis among intravenous (IV) drug abusers is increasing in prevalence in modern societies and as such repair is preferred over replacement. The final appearance was to be of a competent valve with the new pericardial patch, with prolene sutures tied together at the base. The neo-chorde suture ligated at the tip of the patch and fixed with a titanium clip. The illustrations were completed in pencil and colour enhancements added using Photoshop.