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Chronic total occlusion of the left main coronary artery with normal left ventricular motion: the occluded site

Kuniyuki Shirasawa, Myung-Woo Hwanga, Yoshio Sasaki

    International Journal of Cardiology
    |August 30, 2008
    PubMed

    Insights

    Chronic total occlusion of the left main trunk (LMT) is rare and often fatal. This case highlights a 38-year-old female with LMT occlusion successfully treated with coronary artery bypass graft surgery.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Radiology

    Background:

    • Total occlusion of the left main trunk (LMT) is a critical condition, rarely diagnosed due to high mortality.
    • Chronic LMT occlusion is exceptionally uncommon, posing diagnostic challenges in differentiating it from other severe coronary artery diseases.

    Observation:

    • A 38-year-old female presented with exertional angina and dyspnea, with a history of suspected LMT occlusion two years prior.
    • The patient remained asymptomatic for daily activities despite the suspected chronic total occlusion of the left main trunk.

    Findings:

    • Three-dimensional computed tomography (3-D CT) confirmed chronic total occlusion of the left main trunk.
    • Coronary artery bypass graft (CABG) surgery was performed, leading to complete resolution of ischemic symptoms.

    Implications:

    • This case underscores the importance of advanced imaging like 3-D CT in diagnosing rare coronary artery anomalies.
    • Successful surgical intervention (CABG) can effectively manage chronic total occlusion of the LMT, improving patient outcomes.

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