Abstract
A 74-year-old male patient was admitted in our centre to undergo surgical correction of severe mitral regurgitation. He was diabetic with peripheral vasculopathy. Among the preoperative examinations, an echocardiogram reported mild left ventricular dilatation and dysfunction while the coronary angiography did not show significant coronary stenosis (Fig. 1A and Video 1). A minimally invasive right anterolateral thoracotomy access was chosen, with femoral vein and axillary artery cannulation for cardiopulmonary bypass (CPB). The mechanism of mitral regurgitation was both anterior and posterior leaflet prolapse. After an unsuccessful attempt to repair the valve, it was replaced with an SJM Epic® 29 mm bioprosthesis (St Jude Medical, St Paul, MN, USA). Total CPB time was 300 min, and X-clamp time was 167 min, with cold blood cardioplegia administered every 20 min in an antegrade fashion through a vent in the ascending aorta. At the end of the procedure, routine de-airing procedures were performed under transoesophageal echo guidance. However, doi:10.1093/mmcts/mmv003 published online 2015.
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