Early graft failure complicating coronary artery bypass surgery for anomalous left coronary artery from the right coronary sinus.

Anomalous left coronary artery from the right sinus is a recognized cause of myocardial ischemia, ventricular arrhythmia, and sudden cardiac death. The optimal management remains controversial with potential options including coronary artery bypass grafting with or without native vessel ligation, coronary artery re-implantation, and surgical un-roofing. In the case presented, bypass grafting of an anomalous left coronary artery was complicated by early graft failure due to competitive flow from the native vessel. <Learning objective: Coronary artery bypass grafting of coronary arteries with anomalous origin may be complicated by early graft failure resulting from competitive flow from the native vessel. The optimal management remains controversial but the surgical treatment chosen should be considered carefully.>.