Key result
Coronary artery bypass grafting successfully treated a 40-year-old woman with congenital atresia of the left main coronary ostium, with patent grafts at 1 year and no cardiovascular events over a 5-year follow-up.
Case Report (n=1)
No
CABG is an effective and durable treatment for the rare anomaly of congenital atresia of the left main coronary ostium.
CABG may offer durable revascularization for congenital left main atresia; leaves open optimal strategy and generalizability pending larger series.
Congenital atresia of left main coronary ostium is a rare congenital coronary anomaly. This anomaly was detected during elective coronary angiogram in a 40 year-old female patient with chest pain and exertional dyspnea. Treadmill exercise test demonstrated 2 mm upslope depression of ST segment at stage I and the test was terminated due to chest pain. Myocardial stress SPECT using Tl-dipyridamole showed reversible perfusion defects at anterior, apex and lateral wall. It was impossible to select left coronary artery ostium and right coronary angiogram revealed 30% eccentric stenosis at proximal right coronary artery with grade 3 collateral flow to left anterior descending and circumflex arteries. Operative finding revealed totally occluded left coronary ostium with membranelike, non-atheromatous tissue similar to aortic wall. The patient was successfully treated with coronary artery bypass grafts (CABG) using left internal mammary artery and great saphenous vein. She underwent follow-up coronary angiogram, which revealed patent grafts, at one year after CABG and no cardiovascular event was observed on 5-year clinical follow-up. (Korean Circulation J 1998;28(10):1794-1797)
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Park et al. (1998) conducted a case report in Congenital atresia of left main coronary ostium (n=1). Coronary artery bypass grafts (CABG) was evaluated on Cardiovascular events at 5-year follow-up. Coronary artery bypass grafting successfully treated a 40-year-old woman with congenital atresia of the left main coronary ostium, with patent grafts at 1 year and no cardiovascular events over a 5-year follow-up.
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