Abstract
### Case Report A 50-year-old male patient with a past medical history of severe mitral stenosis and tricuspid regurgitation secondary to rheumatic valvular heart disease was admitted to the hospital with heart failure New York Heart Association class IV. Thirteen years before admission, the patient underwent coronary artery bypass graft surgery due to three-vessel atherosclerotic disease. Successful long-term bypass patency shown in cineangiocoronariography was performed on admission. Mechanical mitral valve replacement and tricuspid valvuloplasty with 170 minutes of extracorporeal circulation and 110 minutes of aortic crossclamping time were attempted. The patient developed recurrent, nonsustained ventricular tachycardia with global myocardium ischemia and was admitted to the intensive-care unit with refractory cardiac shock and Kidney Disease Improving Global Outcomes stage …
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