Surgical Management of a Critical Ischemic Mitral Regurgitation Patient.

Functional ischemic mitral regurgitation is strongly associated with poor outcomes in patient with coronary artery disease. The best management for mitral regurgitation at the time of coronary revascularization remains controversial. We report, a case of 58 years-old men admitted to GKNM hospital, Coimbatore, Tamil Nadu, India with chest pain and respiratory distress for last 6 hours during my fellowship training in that hospital. ECG showed acute antero-septal MI. The transthoracic echocardiogram revealed severe left ventricular dysfunction with moderate mitral regurgitation. Coronary angiogram revealed triple vessels disease. We planned for early CABG. But the patient suddenly developed severe respiratory distress with ventricular tachycardia. Patient managed with the support of invasive ventilation and IABP. After that, CABG along with mitral valve repair was done under cardiopulmonary bypass. The patient showed excellent symptomatic improvement during his early post-operative period. Mitral valve repair along with CABG may be a preferable treatment option for patient with Ischemic heart disease with moderate mitral regurgitation.