Atresia of the left main coronary artery: repair with left internal mammary artery bypass.

The case of a 17-month-old child with atresia of the left main coronary artery and mitral insufficiency is presented. The child underwent two separate surgical procedures, the first being a left internal mammary-left anterior descending coronary artery bypass and plication of the mitral valve. During the follow-up period the mitral insufficiency progressed, and the child subsequently underwent mitral valve replacement with a Björk-Shiley prosthesis. A selective study of the left internal mammary demonstrated excellent flow into the left coronary artery system. The report illustrates the use of the left internal mammary artery in a small child.