Isolated bilateral coronary artery ostial stenosis is a rare condition that has been associated with various diseases. We present the case of a 47-year-old male with bilateral coronary ostial stenosis. The patient's history was not significant for systemic diseases. The aorta had prominent signs of aortitis of unknown etiology, possibly due to a chronic mycotic process. The patient underwent emergency surgery and had an uneventful course. The two-year follow up is excellent.

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