Right coronary artery occlusion by cloth from a Starr-Edwards aortic valve prosthesis

We report a case of sudden onset of angina 11 years after implantation of a No. 8 Model 2300 Starr-Edwards cloth-covered aortic valve prosthesis for aortic stenosis and insufficiency. At operation the cloth covering one strut of the metal cage was tenuously attached to the ring of the prosthesis, with its free end completely occluding the right coronary artery ostium. The valve was replaced and the obstructing foreign body removed, re-establishing the patency of the right coronary artery.