Background
Combined coronary artery mitral valve disease is a major cause of morbidity and mortality in the adult patient population. Traditional treatment involves combined mitral valve and CABG surgery using a median sternotomy. However, this combined surgical approach confers a higher risk when compared with isolated MV surgery, the risks of such a combined surgical procedure may outweigh the benefits. Thus, the concept of parsing the total risk of a single major procedure to the lesser individual and summed risks of 2 smaller procedures—percutaneous coronary intervention (PCI) plus the mitral valve operation—has been applied in clinical practice and reported by various groups.
Interest in hybrid procedures, defined for the purpose of this thesis as Mitral valve surgery and percutaneous coronary intervention (PCI), has intensified with improved coronary stent technology, increased collaboration between cardiac surgeons and interventional cardiologists, and the introduction of hybrid operating suites. The complementary goals of minimizing the morbidity of surgical procedures and optimizing resource utilization have driven development of new solutions for concurrent valvular and coronary heart disease (1).