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Perioperative ST-segment Elevation Myocardial Infarction during Mitral Valve Annuloplasty: Role of Early Angiography

Beatriz Vaquerizo, Antonio Serra and Juan García-Picart

Iatrogenic myocardial infarction is a rare complication of valve surgery, most commonly mitral valve replacement. Few cases have been described related to mitral annuloplasty and none have been reported when using minimally invasive valve repair. We present two cases of iatrogenic acute ST-segment elevation myocardial infraction after surgical repair of the mitral valve and prosthetic annuloplasty, one of them after minimal invasive surgery. Emergent cardiac catheterization was performed suggesting different underlying mechanisms. We discuss possible mechanisms, prevention and management of this rare but important complication, highlighting the role of early angiography to elucidate the cause and guide the strategy.