[Aortocoronary bypass for coronary ostial stenosis following aortic valve replacement: a report of successfully treated case].

A 62-year-old man underwent aortic valve replacement with a Medtronic-Hall valve (21 mm) for aortic stenosis and regurgitation with normal coronary arteries. An intermittent selective coronary perfusion with metal tip cannula was employed for both the coronary arteries. Postoperative course was uneventful. However, he began to complain of chest pain six months later. Cardiac catheterization and coronary arteriography revealed a normally functioning valve with 75% stenosis at the main trunk of the left coronary artery. Coronary bypass grafting using a saphenous vein was successfully performed to the left anterior descending coronary artery and the circumflex of the coronary artery. Whenever this fatal complication of the coronary ostial stenosis is recognized, earlier coronary revascularization should be recommended to save the severely ill patient.