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).