Anomalous origin of left main coronary artery from right sinus of Valsalva: modified surgical treatment to avoid neo-coronary ostial stenosis.

A young symptomatic patient is reported with anomalous origin of the left main coronary artery from the right sinus of Valsalva and two stenoses in the intramurally coursing segment of the vessel, namely at the site of the intercoronary commissure and at its exit site in the left sinus of Valsalva. Unroofing of the intramural segment and a modified angioplasty technique resulted in a widely patent neo-coronary ostium.