Hemodynamic abnormalities across an anomalous left main coronary artery assessment: evidence for a dynamic ostial obstruction.

Anomalous left main coronary arteries have been associated with sudden cardiac death, especially when arising from the right coronary cusp and following an anterior course. To date, imaging procedures have been the mainstay of the decision-making process in determining which patients should undergo surgery for correction of this anomaly and which patients are presumed to be at low risk. We report on the hemodynamic evaluation of an anomalous left main performed in support of elected surgical correction in a young patient.