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Introduction: The majority of patients with Marfan syndrome undergo Bentall procedure. Several periprocedural complications may arise; cardiac complications play the most dominant role.

Case presentation: A patient with Marfan syndrome developed symptoms two years after the Bentall procedure. Coronary CT angiography revealed bilateral coronary ostial stenosis. Percutaneous coronary intervention was performed, and two drug-eluting stents were implanted.

Conclusions: Coronary CT angiography is a valuable tool for the examination of symptomatic patients following surgical aortic root replacement.

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