Complete obstruction of the left main coronary artery associated with congenital pulmonary valvular stenosis.

The surgical treatment of the completely obstructed left main coronary artery is aortocoronary saphenous-vein bypass to the left coronary artery system. Without surgical intervention, this lesion has an exceedingly poor prognosis. This report describes a patient with atherosclerotic obstruction of the left main coronary artery and congenital pulmonary valvular stenosis, an unusual combination of lesions not previously documented together. The patient remains asymptomatic 22 months after aortocoronary saphenous-vein bypass and pulmonary valvotomy.