Combined surgery for ischemic cardiomyopathy: report of a case

Area of Science:

• Cardiology
• Cardiac Surgery
• Heart Failure Management

Background:

• Severe ischemic cardiomyopathy presents complex challenges, often involving multi-vessel coronary artery disease, mitral valve regurgitation, and left ventricular dysfunction.
• Patients with catecholamine-dependent ischemic cardiomyopathy require advanced therapeutic strategies due to disease severity and limited treatment options.

Observation:

• A 65-year-old female patient with catecholamine-dependent ischemic cardiomyopathy presented with severe triple vessel coronary artery disease, severe mitral valve regurgitation, and significant left ventricular (LV) dilatation with low ejection fraction.

Findings:

• The patient underwent successful combined surgical procedures including coronary artery bypass grafting (CABG) with four distal anastomoses, mitral valve plasty using an original papillary muscle application method, LV volume reduction via an overlapping technique, and biventricular pacing.
• The postoperative course was uneventful, with the patient demonstrating a good quality of life two years after the complex surgical intervention.

Implications:

• Active combined surgical interventions offer a promising approach for improving clinical outcomes and long-term quality of life in patients suffering from severe ischemic cardiomyopathy.
• This case highlights the potential benefits of comprehensive surgical management, integrating revascularization, valve repair, ventricular reconstruction, and pacing in a single operative session for complex cardiac conditions.