Left main coronary artery stenosis following surgical valve replacement: changing valvular into ischemic heart disease.

Left main stem coronary artery (LMSCA) stenosis after surgical aortic valve replacement (AVR) is a rare but potentially lethal complication. Among the different possible causes, antegrade cardioplegia for direct coronary perfusion seems to be the most significant and prevalent. Here we discuss two cases of late presentation of iatrogenic coronary ostial stenosis following valve replacement surgery. Both cases were successfully treated with percutaneous intervention and stent implantation.