Triple Cardiac Procedure Through Left Periareolar Incision: Coronary Artery Bypass, Mitral Valve Repair, and Ventricular Pseudoaneurysm Repair

Minimally invasive techniques offer advantages over sternotomy for cardiac surgery. We report a triple combined procedure-coronary artery bypass grafting, mitral valve repair, and left ventricular pseudoaneurysm repair-performed through a single left periareolar incision by using an endoscopic-assisted approach in a 54-year-old man with ischemic cardiomyopathy. The operation and recovery were uneventful. Postoperative imaging confirmed competent valve function, improved ejection fraction, restored ventricular geometry, and graft patency. At 30 days, the patient showed stable cardiac function and excellent cosmetic healing. This case demonstrates the feasibility and potential benefits of extending the periareolar approach to complex cardiac procedures with favorable outcomes.