ABSTRACT
There are numerous possible reasons for the development of angina pectoris following aortic valve replacement (AVR): new, progressive or recurrent coronary disease, direct injury to the coronary artery, coronary embolism, the sequelae of coronary perfusion, malposition of the valve or encroachment by excessive pannus. Ostial stenosis has been recognized as a complication of balloon perfusion catheters and plaque disruption or a jet lesion may result from cardioplegic infusion.1-3 Subcoronary implantation of a stentless porcine bioprosthesis raises the concern of intimal hyperplasia (tissue creep) obstructing the coronary orifice.
