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Eur J Cardiothorac Surg 1999;15:209-212
© 1999 Elsevier Science NL

Case report

Anomalous origin of the left main coronary artery: anatomical correction and concomitant LIMA-to-LAD grafting¹

The Department of Cardiothoracic Surgery, Carmel Medical Center, The Technion, Israel Institute of Technology, Haifa, Israel

Received 20 September 1998; received in revised form 30 November 1998; accepted 8 December 1998.

^* Corresponding author. 7 Michal St., Haifa 34362, Israel. Tel.: +972-4-825-0256; fax: +972-4-834-3554; e-mail: mdwolf@tx.technion.ac.il

A 55-year-old woman with angina pectoris and exertional dyspnea underwent surgical correction of an anomalous left main coronary artery (LMCA) originating from the right sinus of Valsalva. During the operation, the roof of the intramurally coursing LMCA was opened into the aortic lumen, and a neo-coronary ostium was created by suturing the circumference of the LMCA intima to the aortic intima. In addition, a left internal mammary artery (LIMA) to left anterior descending (LAD) coronary artery anastomosis was performed. Post-operative coronary angiography demonstrated two independent, patent orifices of both the LMCA and the right coronary artery. The technique presented herein, of combined anatomical correction and LIMA-to-LAD grafting, is feasible and leads to distinct angiographic and clinical improvement.

Key Words: Anomalous coronary artery • Anatomical correction • Grafting

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