This post refers to two intriguing presentations of this year’s EACTS meeting, held in Vienna. Both presentations deal with the chronically ischemic mitral valve (graded at least moderate) as a concomitant finding in patients qualifying for coronary artery bypass grafting. The indication for revascularization is an important differentiator: chronic mitral regurgitation due to past myocardial infarction can also be an entity by itself (i.e. without the need for a revascularization procedure). This entity poses a delicate and difficult question on the best option of how to deal with it. Surgery does not always deliver the desired result, the newer interventional option of Mitraclip® is currently in evolving investigation. I will come back to this issue with a dedicated post. Stay tuned!
Our clinical situation:
Let’s start with the most important thing: the patient is alive and well, hence the word “relative” mentioned in the title. This is “just” about a “technical” defeat. A brief description of the case: patient with severe coronary artery disease and a severe mitral valve regurgitation with indication to surgery (aortocoronary bypass with 4-5 grafts on all three main coronary artery branches and mitral valve repair).