Transconal Unroofing of Anomalous Left Main Coronary Artery From Right Sinus With Trans-septal Course.

Anomalous aortic origin of the left main coronary artery arising from the right coronary sinus with a trans-septal course are rare and pose surgical challenges not addressed by current techniques. Coronary artery bypass grafting, although a plausible solution, has an unacceptably high incidence of graft failure due to competitive flow. We describe a novel transconal approach to effectively unroof the trans-septal left main coronary artery.