Surgical correction of anomalous left coronary artery from the anterior sinus of valsalva.

Origination of the left main coronary artery from the anterior sinus of Valsalva is a rare congenital anomaly that has been associated with sudden death. Anatomical correction of this defect has only rarely been performed by unroofing the intramural segment of the proximal coronary artery or by widening the narrowed angulated origin of this anomalous vessel. This report describes the clinical course of a 33-year-old woman with this anomaly who experienced episodes of chest tightness associated with ischemic electrocardiographic changes. Surgical correction was performed by enlarging the ostium of the anomalous artery with a "sphincteroplasty" technique. Thallium scanning, which was positive prior to surgery, was normal postoperatively. The patient remains asymptomatic 6 months after surgical correction.