[Mitral annuloplasty and coronary artery bypass grafting (CABG) with on-pump beating via left thoracotomy for ischemic mitral valve regurgitation with patent internal thoracic artery( ITA) grafts after CABG;report of a case].

A 69-year-old man was admitted with progressive congestive heart failure due to ischemic mitral valve regurgitation. He had previously undergone coronary artery bypass grafting( CABG) using bilateral internal thoracic arteries( ITAs) and saphenous vein grafts( SVG). An angiogram revealed patent bilateral ITAs and stenosis of the SVG affecting the left circumflex (LCX) branch, which persisted despite repeated catheter intervention. Patent ITA grafts were located immediately beneath the sternum. We performed a mitral annuloplasty and CABG( SVG-LCX) simultaneously with on-pump beating via left thoracotomy. Postoperative course was uneventful and mitral valve regurgitation disappeared with patent SVG-LCX.