Alternative Approach for the Surgical Treatment of Left Main Coronary Artery Aneurysm.

Left main coronary artery (LMCA) aneurysm is a very rare condition that usually requires surgical treatment. Although there is no consensus on the standard surgical technique, aneurysmal ligation with coronary artery bypass grafting is commonly used. This report presents a case of a giant LMCA aneurysm for which an alternative surgical approach was performed. The aneurysm was incised and partially resected. An interposition right internal thoracic artery graft from the LMCA to the left circumflex coronary artery was placed together with a left internal thoracic artery and free right internal thoracic artery graft. Postoperative imaging showed good patency of all grafts. This case demonstrates an effective approach for the surgical treatment of LMCA aneurysm that offers an alternative when other techniques are not desirable.