Composite Y-graft for syphilitic ostial stenosis in left main coronary artery.

Coronary ostial stenosis is one of the cardiac manifestations of tertiary syphilis and should be perceived as a disorder of the aorta. A 45-year-old man with no coronary risk factors except smoking developed severe isolated ostial stenosis in the left main coronary artery. He underwent emergency bypass surgery using the bilateral internal thoracic arteries as a composite Y-graft, and recovered uneventfully.