Introduction:
The concept of performing cardiac surgery on a beating heart is a viable rationale these days. In some cases, surgeons are forced to perform surgery on a beating heart because it is the only option available. The most common approach for standard MV replacement is median sternotomy, aorti-bicaval bypass at 320C and anterograde cardioplegia to arrest the heart(1). In addition, cardiac reperfusion injury is a well-recognized complication that occurs after ischemia or cardioplegia. As a result, various strategies have been developed to prevent ischemic reperfusion injury such as surgery on a beating heart (2). This case report emphasizes the importance of preoperative assessment for cardiac surgery planning.