Surgical Aortic Valve Replacement With Nicks Annular Enlargement and Partial Trimming of a Protruding Left Main Coronary Stent.

Protrusion of a coronary stent into the aortic root is rare and can complicate aortic valve replacement and future coronary access. We report the case of a 76-year-old woman with severe aortic stenosis and a left main coronary stent protruding approximately 1 cm into the aortic root. Given the small aortic annulus and the risk of mechanical interference, surgical aortic valve replacement with the Nicks annular enlargement was performed. The protruding stent segment was selectively trimmed while preserving the intraluminal portion, with concomitant coronary bypass grafting. The postoperative course was uneventful.