Minimally invasive valve surgery with bypass to the right coronary artery.

Herein, we report the case of a 60-year-old woman who presented with increasing dyspnea on exertion. Echocardiography revealed significant aortic and mitral regurgitation, which were most likely secondary to previous radiation therapy for breast cancer. On cardiac catheterization a 90% ostial right coronary artery lesion was found and treated with a drug-eluting stent. During minimally invasive valve surgery, via a right anterior thoracotomy, it was noted that the stent had restenosed. Therefore, the right coronary artery was bypassed with a segment of venous graft through the same incision.