Mitral valve surgery has become an increasingly common procedure for patients with mitral valve disease. Iatrogenic coronary artery lesion has been reported as an uncommon and potentially fatal complication of mitral valve surgery. Its diagnosis must be considered during perioperative care, and coronary angiography helps in deciding the best therapeutic strategy. In the present clinical report, we describe a patient with iatrogenic occlusion of the left circumflex artery after surgery for mitral valve replacement due to rheumatic disease.
Iatrogenic occlusion of the left circumflex artery due to mitral valve repair surgery: a not well-known, but potentially fatal complication
Duarte,Paulo Vinicios Falcão and Côrtes,Leandro Assumpção and Nascif,Gibran Bhering and Milanesi,Paulo André Grazziotti and Freitas,Vanessa Pimenta Bueno and Ribeiro,Marcelo Lemos. Iatrogenic occlusion of the left circumflex artery due to mitral valve repair surgery: a not well-known, but potentially fatal complication. J Transcat Intervent. [online]. 2019, vol.27, [cited 2026-03-06], Available from: <https://jotci.org/article/iatrogenic-occlusion-of-the-left-circumflex-artery-due-to-mitral-valve-repair-surgery-a-not-well-known-but-potentially-fatal-complication/>. ISSN . http://doi.org/10.31160/JOTCI201927A20180004.
Duarte,Paulo Vinicios Falcão; Côrtes,Leandro Assumpção; Nascif,Gibran Bhering; Milanesi,Paulo André Grazziotti; Freitas,Vanessa Pimenta Bueno; Ribeiro,Marcelo Lemos. Iatrogenic occlusion of the left circumflex artery due to mitral valve repair surgery: a not well-known, but potentially fatal complication. J Transcat Intervent., v.27, Apr. 2019. Available from: <https://jotci.org/article/iatrogenic-occlusion-of-the-left-circumflex-artery-due-to-mitral-valve-repair-surgery-a-not-well-known-but-potentially-fatal-complication/>. acess on 06 Mar. 2026. http://doi.org/10.31160/JOTCI201927A20180004.
Duarte,Paulo Vinicios Falcão, & Côrtes,Leandro Assumpção, & Nascif,Gibran Bhering, & Milanesi,Paulo André Grazziotti, & Freitas,Vanessa Pimenta Bueno, & Ribeiro,Marcelo Lemos. (2019). Iatrogenic occlusion of the left circumflex artery due to mitral valve repair surgery: a not well-known, but potentially fatal complication. J Transcat Intervent., 27, http://doi.org/10.31160/JOTCI201927A20180004.
DuartePaulo Vinicios Falcão, CôrtesLeandro Assumpção, NascifGibran Bhering, MilanesiPaulo André Grazziotti, FreitasVanessa Pimenta Bueno, RibeiroMarcelo Lemos. Iatrogenic occlusion of the left circumflex artery due to mitral valve repair surgery: a not well-known, but potentially fatal complication. J Transcat Intervent. [Internet]. 2019 Apr [cited 2026 Mar 06]; 27: Available from: https://jotci.org/article/iatrogenic-occlusion-of-the-left-circumflex-artery-due-to-mitral-valve-repair-surgery-a-not-well-known-but-potentially-fatal-complication/. http://doi.org/10.31160/JOTCI201927A20180004.
Figure 3
Immediate postoperative coronary angiography. (A) Occlusion of the left circumflex artery. (B) Pre-dilation of coronary stenosis with non-compliant balloon. (C) Bare-metal stent implanted, illustrating a waist in the balloon at the site of the stricture. (D) Post-dilatation of the stent using non-compliant balloon. (E and F) Angiographic views after the procedure.
