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Updated: Jun 19, 2026

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Distortion of the proximal circumflex artery during mitral valve repair
Antonio M Calafiore1, Angela L Iacò, Egidio Varone
1Department of Adult Cardiac Surgery, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia. calafiore@unich.it
Insights
Severe lateral ischemia occurred in a patient post-mitral valve repair. Marginal branch revascularization successfully restored circumflex artery blood flow, ensuring graft patency.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Cardiac Imaging
Background:
- Mitral valve repair is a common procedure for severe mitral regurgitation.
- Ischemia can be a rare complication following cardiac surgery.
- Maintaining coronary artery patency is crucial for surgical success.
Observation:
- A 74-year-old female patient developed severe lateral ischemia post-mitral valve repair.
- Electrocardiogram (ECG) indicated significant myocardial ischemia without hemodynamic compromise.
- Coronary angiography revealed a critical occlusion in the proximal circumflex artery.
Findings:
- The patient underwent successful on-pump beating heart marginal branch revascularization.
- The procedure addressed the circumflex artery occlusion.
- Post-procedure angiography confirmed a widely patent and successful bypass graft.
Implications:
- This case highlights the importance of prompt diagnosis and intervention for post-operative ischemia.
- Marginal branch revascularization is an effective strategy for managing complex coronary artery issues during mitral valve surgery.
- Successful graft patency ensures improved myocardial perfusion and patient outcomes.
Abstract:
A 74-year-old woman showed electrocardiographic signs of severe lateral ischemia with no hemodynamic consequence after mitral valve repair for severe mitral regurgitation. An angiogram showed interruption of the proximal circumflex artery. The patients then underwent an on-pump beating heart marginal branch revascularization. A new angiogram performed before discharge showed a widely patent graft.
Related Concept Videos
Mitral Stenosis I: Introduction
Mitral Valve Prolapse I: Introduction
Mitral Regurgitation I: Introduction
Mitral Stenosis II: Clinical features and Diagnostic Tests
Mitral Stenosis III: Medical Management
Mitral Valve Prolapse II: Assessment and Management

