Situation Awareness for Circumflex Artery Injury During Mitral Valve Surgery

Injury of the circumflex artery (Cx) during mitral valve surgery is a rare and underrecognized life-threatening complication. A retrospective analysis of patients undergoing mitral valve operations at 2 centers was conducted. Five mitral valve operations are described. After diagnosis of Cx injury, 2 patients were treated by stent implantation, 1 by coronary bypass to the Cx, and 1 by repositioning the responsible annular stitches. In another patient, the Cx injury was not treated and was diagnosed at autopsy. There were no deaths in patients whose Cx injury was promptly treated. Cx injury can be successfully managed when it is treated on time.