Surgical treatment of left main coronary aneurysm

Aneurysms of the coronary arteries occur in 0.3% to 4.9% of angiograms. Only 13 cases of left main artery (LMA) aneurysms have been reported. Of these, three were treated by ligation of the aneurysm and coronary revascularization; the others by revascularisation alone. We report the case of a 56 years old man presenting with unstable angina and previous history of myocardial infarction. Coronary angiography confirmed three vessels disease and the presence of an aneurysm of the LMA extending to the proximal part of the left anterior descending artery (LAD). The patient was treated with ligation of the aneurysm and total myocardial revascularization. The clinical and radiological features are reviewed, and the surgical options considered.