Bilateral coronary ostial stenoses post-Bentall procedure: management options in the DES era.

The Bentall procedure for aortic root and valve replacement with coronary reimplantation was initially described in 1968. This procedure is considered the "gold standard" for treatment of combined valve and ascending aortic pathology. The procedure is performed most commonly in patients with degenerative aortic disease, including atherosclerotic disease, ectasia and poststenotic aortic dilatation. The complication of single coronary ostial stenosis following reimplantation is extremely rare in this procedure, occurring in less than 2% of patients. We describe the first case of bilateral coronary ostial stenoses following the Bentall procedure in a patient with documented heparin-induced thrombocytopenia (HIT) that was successfully treated with percutaneous coronary intervention (PCI).