Occlusion of Abnormal Circumflex Coronary Artery During Mitral Valve Repair

In the case report, we describe a rare but interesting complication after a totally endoscopic robotic mitral valve repair in a patient with severe mitral regurgitation.The mitral valve was repaired robotically using standard techniques, and the intraoperative trans-esophageal echocardiogram demonstrated no residual mitral regurgitation.However, there was unexpected hypokinesia of the posterior and lateral walls of the left ventricle, with subsequent EKG showing acute ST elevations of the lateral segment.Immediate cardiac catheterization revealed occlusion of the left circumflex artery.Aspiration thrombectomy was performed and a drug-eluting stent placed to restore the contour, thus preventing potential patient morbidity.