title: Coronary ostial stenosis after aortic valve replacement.
abstract: Coronary ostial stenosis is a life-threatening complication of aortic valve replacement. We describe the case of a patient who developed symptoms and signs related to coronary insufficiency 4 months after aortic valve replacement. In view of a coronary angiogram revealing a 99% left main stem stenosis, an urgent revascularization procedure was performed. Intraoperative inspection revealed a dense fibrous reaction of the aortic root involving the left coronary ostium. The postoperative course was uneventful and since the operation the patient remained asymptomatic. The possible mechanisms involved in the pathogenesis of coronary ostial stenosis after aortic valve replacement and the surgical strategy to be employed for the treatment of this complication are discussed.
authors.affiliation: Division of Cardiovascular Surgery, Cardiovascular Department, San Carlo Hospital, Potenza, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Tomasco
authors.forename: Maurilio
authors.initials: M
authors.lastname: Di Natale
authors.forename: Carmine
authors.initials: C
authors.lastname: Minale
mesh_terms: D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D023921:Coronary Stenosis / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D017211:Treatment Failure