Ostial Left Main Stenosis following Repair of a Ruptured Sinus of Valsalva Aneurysm

A patient complained of angina pectoris nine months after surgical repair of an aortic right atrial fistula and mitral valve replacement. Subsequently, he was shown to have a new obstruction of the ostium of the left main coronary artery. This case illustrates the need to consider this syndrome in the differential diagnosis of postoperative complaints of chest pain, especially following an operation which involves direct cannulation of the coronary arteries.