Resection and Reimplantation of a Nearly Atretic Left Main Coronary Artery in an Adolescent

Congenital coronary artery stenosis is a rare coronary anomaly with significant variability in presentation and management. We present a case of severe left main coronary artery stenosis in a young female. A 14-year-old female was referred to the Cardiology Clinic for multiple episodes of syncope and presyncope with activity that began in early childhood. Diagnostic imaging revealed near atresia of the proximal left main coronary artery. The patient underwent surgical repair with resection of the stenotic coronary artery portion, ostial revision, and coronary reimplantation. The patient tolerated the procedure well with reassuring 2-month postoperative imaging and normal cardiopulmonary exercise testing at 6-months post-surgery. Resection and reimplantation is a viable surgical option for cases of severe congenital proximal coronary artery stenosis.