Coronary ostial stenosis, a complication of aortic valve replacement

Eight patients developing coronary ostial stenosis following Starr-Edwards aortic valve placement are reviewed. Coronary perfusion with a balloon tip perfusion catheter was performed during the intraoperative period on all patients and was considered technically satisfactory. Angina pectoris developed within six months of surgery in seven of eight patients and left main coronary artery occlusive disease was demonstrated in each of these cases. One patient who did not develop angina pectoris had right coronary artery narrowing without intraoperative perfusion of this vessel. All patients were reoperated, five survived, two are free of symptoms. Coronary ostial stenosis is a clinically recognizable complication of aortic valve replacement with potential for surgical correction.