Isolated congenital atresia of the left main coronary artery and atherosclerosis.

Successful surgical revascularization in an adult with isolated congenital atresia of the left main coronary artery with coexistent two-vessel atherosclerosis is described. This extremely rare anomaly must be differentiated from single right coronary artery and acquired occlusion of the left main coronary artery. Symptomatic myocardial ischemia in patients surviving to adulthood is an indication for surgical revascularization in them.