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Off Pump Minimally Invasive Treatment of Severe Degenerative Mitral Valve Disease and Concomitant Coronary Artery Disease: Hybrid Approach

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Off Pump Minimally Invasive Treatment of Severe Degenerative Mitral Valve Disease and Concomitant Coronary Artery Disease: Hybrid Approach
Agne Drasutiene1, Kestutis Rucinskas1, Arturas Lipnevicius1, Vilius Janusauskas1, Diana Zakarkaite1, Rita Kramena1, Robertas Samalavicius2, Audrius Aidietis1
1Department of Cardiovascular Medicine, Vilnius University, Vilnius, Lithuania, 2Department of Intensive Care, Centre of Anaesthesia, Intensive Care and Pain Management, Vilnius University, Vilnius, Lithuania.

OBJECTIVE: To present successful hybrid procedure for treating severe mitral valve regurgitation and concomitant coronary artery disease.
METHODS: There were two patients treated with hybrid procedure.
1st patient - 79 years old symptomatic (NYHA III) male with severe mitral valve regurgitation and concomitant two coronary artery disease (ROM - 90% and LAD -75%).
2nd patient - 86 years old symptomatic male (NYHA III) with severe mitral valve regurgitation and concomitant single vessel disease (LAD - 75%).
Patients had degenerative mitral valve regurgitation with eccentric jet due to wide P2 prolapse.
Both patients have undergone coronary stenting followed by off pump transapical implantation of artificial chordae. 1st patient had 3 chords implanted to P2 segment. 2nd patient had 4 chords implanted to P2 segment.
RESULTS: None of the patients had any serious adverse events. Both patients have improvement of symptoms (NYHA II), and had MR 1+ at one month follow up.
CONCLUSIONS: Hybrid procedure (coronary artery stenting followed by off pump transapical implantation of artificial chordae) is an option for treating patient with severe mitral valve regurgitation and concomitant coronary artery disease.

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