Suspicion of intraoperative left main coronary artery extrinsic compression with Perceval® sutureless bioprosthesis

We present an uncommon case of intraoperative transient myocardial ischemia related to suspicion of left main stem artery extrinsic compression caused by the radial force of the stent of Perceval® bioprosthesis. No other cases have been described, but some similarities can be found with extrinsic coronary compression in percutaneous pulmonary valves. Surgeons should be aware of this complication in patients with coronary anomalies or with bicuspid anatomy.