Intraseptal Anomalous Coronary Artery with Myocardial Infarction: Novel Surgical Approach.

Anomalous aortic origin of a coronary artery (AAOCA) with an intraseptal course of the left coronary artery (LCA) is a rare anomaly that can cause myocardial ischemia. Surgical technique known to improve outcome is lacking because of the challenging complexity of the anatomy. We herein describe a novel surgical approach in a young athlete with myocardial infarction and ongoing ischemia. Supra-arterial myotomy of the intraseptal segment via a right ventriculotomy and direct reimplantation of the LCA were performed successfully. Following postoperative resolution of inducible myocardial hypoperfusion, the patient was allowed to return to competitive activities with no further symptoms.