Surgical treatment of chronic intestinal ischemia associated with combined valvular disease

A 69-year-old male was admitted with congestive heart failure and postprandial abdominal pain with weight loss. Combined valvular disease (MR III+TR III) was demonstrated by cardiac catheterization. Selective visceral arteriography revealed 75% stenosis at the origin of SMA and common hepatic artery arose beyond the stenosis. SMA-abdominal aortic bypass grafting using auto-saphenous vein graft was performed initially. Postprandial abdominal pain disappeared after bypass grafting, and then MVR with Bjork-Shiley mechanical valve and TAP with Carpentier- Edwards ring was performed.