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.
Percutaneous coronary diagnostic and therapeutic procedures are very frequent worldwide and therefore bring to discussion the best vascular access for each patient. The vascular access for coronary angiography or coronary interventions must be chosen according to the patient's clinical and anatomical characteristics, as well as the experience of the interventional cardiologist. Several studies have shown the superiority of radial access compared to femoral access, reducing local complications, major cardiovascular events, death and hospital costs. The ulnar approach is a feasible and safe option in the absence of radial access.
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