摘要
Rheumatic heart disease is still highly prevalent in .developing countries where the incidence of coronaryartery disease （CAD） is also arising. Consequently the occurrence of coexistent CAD and mitral stenosis （MS） dominantly caused by rheumatic fever is more frequent in these countries. Comorbidities such as pulmonary and renal dysfunction occur frequently in these aging populations. Off-pump surgery is widely applied in patients with concomitant CAD and severe comorbidities due to lower incidence of postoperative morbidity. Closed mitral commissurotomy （CMC） is a well established treatment for patients with mitral stenosis. We report here a case of moderate stenosis combined with seriously diffuse 3-vessel CAD and severe chronic obstructive pulmonary disease （COPD） in an elder male treated with off-pump coronary artery bypass （OPCAB） plus CMC.
Rheumatic heart disease is still highly prevalent in .developing countries where the incidence of coronaryartery disease （CAD） is also arising. Consequently the occurrence of coexistent CAD and mitral stenosis （MS） dominantly caused by rheumatic fever is more frequent in these countries. Comorbidities such as pulmonary and renal dysfunction occur frequently in these aging populations. Off-pump surgery is widely applied in patients with concomitant CAD and severe comorbidities due to lower incidence of postoperative morbidity. Closed mitral commissurotomy （CMC） is a well established treatment for patients with mitral stenosis. We report here a case of moderate stenosis combined with seriously diffuse 3-vessel CAD and severe chronic obstructive pulmonary disease （COPD） in an elder male treated with off-pump coronary artery bypass （OPCAB） plus CMC.
