Dramatic resolution of an immediate postoperative distortion of the circumflex artery during mitral valve surgery

Injury or distortion of the circumflex coronary artery can occur during mitral valve surgery, due to its proximity to the mitral valve annulus. We present the case of a 72-year-old male patient with symptomatic mitral regurgitation, who underwent minimally invasive mitral valve surgery. The initial reparative gesture was complicated by intraoperative infarct due to a distortion of the circumflex artery (CX) caused by the rigidity of the ring used; the mainstay of the treatment was the removal of the previous device implanted in favor of a flexible one with restitutio ad integrum of the CX patency.