Combined surgery for mitral regurgitation associated with extensive annular calcification and left main coronary artery disease.

Although extensive calcification of the mitral annulus is encountered infrequently, it presents a formidable problem in mitral valve surgery. We describe a case of severely calcified mitral annulus associated with grade IV mitral regurgitation in addition to left main coronary artery disease. The patient was a 66-year-old woman who successfully underwent thorough excision of the calcified bar, annular reconstruction with a autologous pericardial strip, mitral valve replacement with a mechanical prosthesis, and double coronary artery bypass grafting using arterial grafts.