Abstract
Complications of myocardial infarction (MI) such as left ventricular aneurysm, chronic ischaemic mitral regurgitation (CIMR) and heart failure are associated with a poor prognosis. The management of complex defects is challenging and requires an individualized strategy. We describe a case of 44-year-old male with multiple complications of MI including heart failure with reduced ejection fraction, left ventricular aneurysm and severe CIMR. We present complex approach, aimed at correcting various components of ischemic cardiomyopathy: relieving ischemia, reducing left ventricular wall tension, reducing volume overload and pulmonary hypertension by mitral valve surgery and left ventricular reconstruction (also known as the Dor procedure). In this case report, we describe the crucial role of echocardiography and magnetic resonance imaging before surgery.
Highlights
Chronic ischemic mitral regurgitation (CIMR) is a disease of left ventricle (LV) and not of mitral valve (MV) itself
CIMR is a frequent complication of coronary artery disease or myocardial infarction (MI) and is associated with adverse prognosis [1,2]
The main mechanism of CIMR is related with dis‐ tortion of the spatial relationships between the MV and papillary muscles (PMs) secondary to ventricular remodeling
Summary
A successful treatment of ischemic cardiomyo pathy associated with left ventricular aneurysm and chronic ischaemic mitral regurgitation (RCD code: III‐1B.9.o).
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