Acute
coronary artery obstruction is a rare but fatal complication of surgical
aortic valve replacement (AVR). Sudden coronary
spasm, embolization of
calcium plaque, and surgical factors can induce
acute coronary syndrome after AVR. Here, we
report a case of left main coronary ostial obstruction that occurred immediately after
weaning from
cardiopulmonary bypass. This case highlights the importance of coronary ostial flow patency and assessment of regional wall
motion abnormalities with intraoperative
transesophageal echocardiography in AVR.