ABSTRACT
A rare case of left coronary ostial stenosis following aortic valve replacement (AVR) was reported. A 67-year-old man had undergone AVR for aortic stenosis and regurgitation. During the procedure basket tip cannula was utilized for selective coronary perfusion. He began to complain of chest pain 4 months after surgery, and coronary arteriography revealed a 99% stenosis at the left coronary ostium. Emergency coronary artery bypass grafting (CABG) to the LAD using a saphenous vein graft was successfully performed. The angina pectoris developing after AVR suggests that coronary ostial injury was caused by selective coronary perfusion cannula. The disease progresses rapidly in the absence of sufficient collaterals, and emergency CABG is needed to prevent critical myocardial infarction and sudden death.