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Cardiology Research and Practice
Volume 2009, Article ID 213954, 3 pages
http://dx.doi.org/10.4061/2009/213954
Case Report

Left Main Coronary Stenosis as a Consequence of Bentall Operation: Percutaneous Treatment

Department of Cardionephrology and Department of Internal Medicine, University of Genova, Viale Benedetto XV/6–16132 Genova, Italy

Received 29 April 2009; Accepted 6 August 2009

Academic Editor: Gerald Maurer

Copyright © 2009 Manrico Balbi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 65-year-old man suffering from ascending aorta aneurysm and atherosclerotic three vessel disease without left main involvement underwent aortic root replacement with coronary ostia reimplantation according to the modified Bentall technique and multiple coronary artery bypass grafts. Gelatin-resorcin-formaldehyde glue was used to reinforce the aortic coronary buttons and to facilitate hemostasis. Five months after surgery, the patient experienced rapidly worsening effort angina. Coronary angiography showed severe left main narrowing. The considerable amount of time that elapsed between surgery and the onset of symptoms implies that the problem was not related to an imperfect suture technique, but was most likely caused by an inflammatory and proliferative response to the glue that had been used. We performed elective percutaneous coronary intervention and stenting of the protected coronary vessel without technical difficulties and with a satisfactory final result. The patient is currently symptom-free after 1 year's follow-up.