Resolution of an Acute Cardiac Ischemia After the Removal of a Surgical Drain in Mitral and Tricuspid Valve Repair

Abstract

A 61-year-old woman was admitted to our institution for severe mitral and tricuspid regurgitation. A transesophageal echocardiogram confirmed a posterior (P2) mitral leaflet flail and a severe dilatation of the tricuspid annulus. No coronary artery disease was demonstrated by angiography. She underwent a mitral and tricuspid valve repair, with triangular resection of the mitral posterior leaflet and annuloplasty of the tricuspid valve. As usual we inserted a mediastinal and a retrocardiac drain. The surgical procedure and the first postoperative course were both uneventful. During the morning of the first postoperative day, after the patient’s mobilization in the intensive care unit, the patient was sweating, and nausea, hypotension, electrocardiographic inferior ST elevation and hypokinesia of the inferior wall on echocardiography had developed. The patient was transferred to the catheterization laboratory for an angioFig 1.