Commentary: Mitral valve annuloplasty and circumflex artery injury: are fewer stitches better?

Myocardial ischemia due to circumflex artery (LCX) occlusion or distortion following mitral valve (MV) surgery carries a poor prognosis and is associated with significant morbidity.1,2 First described in the 1960s, this entity remains a feared complication among mitral valve surgeons despite several technical and perioperative improvements.3 In this regard, Caruso and colleagues4 should be commended for bringing new light to this issue. In a great example of bedside-to-bench-to-bedside study, their group initiated this study to better understand the underlying mechanism of LCX flow disturbance following MV surgery after experiencing 2 unusual cases presenting this complication.