Concomitant Valve Surgery and Long Distal Bypass for Severe Mitral Regurgitation and Critical Limb Ischemia

Mari Chiyoya＊	Satoshi Taniguchi＊	Ryousuke Kowatari＊
Tomonori Kawamura＊	Norihiro Kondo＊	Masahito Minakawa＊
Ikuo Fukuda＊

（Department of Thoracic and Cardiovascular Surgery, Hirosaki University Graduate School of Medicine＊, Aomori, Japan）

A 75-year-old man with underlying arteriosclerosis obliterans presented with acute heart failure secondary to rest pain of the right lower extremity. Echocardiogram showed severe mitral regurgitation, moderate tricuspid regurgitation and a low cardiac function（ejection fraction:27%). Right toe gangrene developed in association with continuous acute heart failure. He underwent mitral valve replacement, tricuspid annuloplasty, right common femoral artery-posterior tibial artery bypass and amputation of the right toes in single-stage surgery. There were no major complications during his hospital stay. After surgery, his symptoms significantly improved.

 

Jpn. J. Cardiovasc. Surg. 46:325-329（2017）

Keywords：mitral valve replacement;tricuspid annuloplasty;critical limb ischemia;distal bypass;arteriosclerosis obliteration