Angioplasty, stenting and thrombectomy to correct left main coronary stem obstruction by a bioprosthetic aortic valve.

Iatrogenic ostial coronary stenosis is a rare life-threatening complication of aortic valve replacement, usually presenting after 2-6 months. Although it is rarely reported, its incidence has been estimated at 0.3-5%. The most likely mechanism is posttraumatic fibrous intimal proliferation caused by coronary ostia cannulation for direct cardioplegia. We report a unique case of early occurrence of thrombotic obstruction of the left main stem following aortic valve replacement and its interventional management.