COMBINED VALVULAR AND CORONARY-ARTERY SURGERY

Combined valvular and coronary surgery is more common every day. Coexi stence of valvular and coronary disease makes a complex setting of phy siopathological interactions, specially in the ischemic mitral regurgi tation. So an ideal surgical strategy, including a thorough knowledge of valvular shape, ventricular function and myocardial reserve, as wel l as new mitral repair techniques and cardioplegic myocardial protecti on is essential. Despite these conditions, combined sugical mortality is higher than in isolated valve or coronary surgery. Severe complicat ions in the early postoperative period and long term follow up are als o more frequent. In any case, combined valvular and coronary surgery r emains a challenge for surgical groups all over the world.